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General NPI Number Information
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NPI Number | 1154275204
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Entity Type | Organization
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Legal Business Name | MONMOUTH OCEAN DENTISTRY
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Dates
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Enumeration Date | 02/25/2026
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Last Update Date | 02/25/2026
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Provider Practice Location Address
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Address Line | 848 W BAY AVE BLDG B
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City | BARNEGAT
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State | NJ
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Zip | 08005-2126
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Country | US
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Telephone | 609-698-5200
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Fax | 609-698-5290
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Provider Business Mailing Address
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Address Line | 848 W BAY AVE BLDG B
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City | BARNEGAT
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State | NJ
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Zip | 08005-2126
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Country | US
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Telephone | 609-698-5200
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KIM YACONO
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Credential |
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Telephone | 732-223-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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