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NPI 1174505382

NPI 1174505382 : JOEL M STORM DDS : MANALAPAN, NJ

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General NPI Number Information
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    NPI Number           |    1174505382
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    Entity Type          |    Individual 
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    Provider Name        |    JOEL M STORM DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/15/2005
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    224 TAYLOR MILLS RD 
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    City                 |    MANALAPAN
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    State                |    NJ
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    Zip                  |    07726-3281
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    Country              |    US
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    Telephone            |    732-462-9500
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    Fax                  |    732-462-5756
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Provider Business Mailing Address
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    Address Line         |    224 TAYLOR MILLS RD 
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    City                 |    MANALAPAN
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    State                |    NJ
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    Zip                  |    07726-3281
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    Country              |    US
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    Telephone            |    732-462-9500
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    Fax                  |    732-462-5756
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    22D101101100
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    License Number State |    NJ
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