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General NPI Number Information
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NPI Number | 1023320058
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Entity Type | Organization
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Legal Business Name | HOBOKEN ORAL SURGERY GROUP
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Dates
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Enumeration Date | 07/07/2010
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Last Update Date | 07/07/2010
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Provider Practice Location Address
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Address Line | 505 E BROAD ST SUITE #3
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City | WESTFIELD
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State | NJ
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Zip | 07090-2190
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Country | US
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Telephone | 908-789-8811
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Fax | 908-789-1729
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Provider Business Mailing Address
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Address Line | 505 E BROAD ST SUITE #3
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City | WESTFIELD
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State | NJ
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Zip | 07090-2190
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Country | US
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Telephone | 908-789-8811
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Fax | 908-789-1729
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Authorized Official
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Title or Position | OWNER
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Name | DR. HUGO QUINONES
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Credential | DMD
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Telephone | 908-789-8811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DI16993
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DI02425000
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DI19578
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License Number State | NJ
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