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General NPI Number Information
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NPI Number | 1124289947
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Entity Type | Organization
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Legal Business Name | SHORE FAMILY DENTAL, P.C.
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Dates
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Enumeration Date | 06/24/2008
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Last Update Date | 04/14/2013
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Provider Practice Location Address
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Address Line | 222 NEW RD CENTRAL PARK EAST, SUITE #803
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City | LINWOOD
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State | NJ
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Zip | 08221-1299
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Country | US
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Telephone | 609-926-3222
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Fax | 609-601-6334
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Provider Business Mailing Address
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Address Line | 222 NEW RD CENTRAL PARK EAST, SUITE #803
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City | LINWOOD
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State | NJ
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Zip | 08221-1299
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Country | US
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Telephone | 609-926-3222
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLAIRE ANITA SPARAGNA
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Credential | DMD
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Telephone | 609-926-3222
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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 | 22DI01559000
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License Number State | NJ
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