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General NPI Number Information
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NPI Number | 1053857680
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Entity Type | Organization
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Legal Business Name | DR. SARAH C. BREVET, LLC
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Dates
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Enumeration Date | 01/06/2017
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 64 MAIN AVE
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City | OCEAN GROVE
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State | NJ
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Zip | 07756-1319
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Country | US
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Telephone | 732-774-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 18 WEBB AVE
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City | OCEAN GROVE
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State | NJ
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Zip | 07756-1334
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | SARAH BREVET
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Credential |
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Telephone | 732-233-5079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22D102152300
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License Number State | NJ
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