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General NPI Number Information
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NPI Number | 1083687149
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Entity Type | Organization
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Legal Business Name | ORAL SURGERY GROUP, PA
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 109 LIVINGSTON AVE
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-2410
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Country | US
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Telephone | 732-247-8083
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Fax | 732-247-1584
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Provider Business Mailing Address
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Address Line | 109 LIVINGSTON AVE
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-2410
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Country | US
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Telephone | 732-247-8083
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Fax | 732-247-1584
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. PHILIP S. ENGEL
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Credential | DMD
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Telephone | 732-247-8083
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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 |
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License Number State | NJ
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