=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013460310
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOBOKEN ORAL SURGEONS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/03/2016
-----------------------------------------------------
Last Update Date | 12/11/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 33-41 NEWARK ST STE 2A
-----------------------------------------------------
City | HOBOKEN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07030-5620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-659-6999
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 33-41 NEWARK ST STE 2A
-----------------------------------------------------
City | HOBOKEN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07030-5620
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-659-6999
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | PAUL CALAT
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 201-659-6999
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223S0112X
-----------------------------------------------------
Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------