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General NPI Number Information
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NPI Number | 1114152766
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Entity Type | Organization
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Legal Business Name | ORAL & MAXILLOFACIAL SURGERY INSTITUTE PC
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Dates
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Enumeration Date | 05/27/2009
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Last Update Date | 05/27/2009
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Provider Practice Location Address
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Address Line | 50 PARK PLACE STE # 1540
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City | NEWARK
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State | NJ
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Zip | 07102
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Country | US
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Telephone | 973-643-1130
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Fax | 973-643-1537
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Provider Business Mailing Address
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Address Line | 50 PARK PLACE STE # 1540
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City | NEWARK
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State | NJ
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Zip | 07102
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Country | US
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Telephone | 973-643-1130
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Fax | 973-643-1537
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN ANTHONY DIRINZO
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Credential | DDS
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Telephone | 973-643-1130
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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 |
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