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General NPI Number Information
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NPI Number | 1174714786
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Entity Type | Organization
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Legal Business Name | DOMINICK CRINGOLI
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 08/08/2007
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Provider Practice Location Address
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Address Line | 400 N MAIN ST
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City | MANAHAWKIN
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State | NJ
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Zip | 08050-3730
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Country | US
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Telephone | 609-597-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 790 LYNWOOD ST
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City | RARITAN
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State | NJ
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Zip | 08869-1318
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Country | US
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Telephone | 609-597-4600
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Fax |
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Authorized Official
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Title or Position | ORTODONTIST
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Name | DR. DOMINICK L. CRINGOLI
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Credential | DMD PA
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Telephone | 609-597-4600
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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 | 22DI00812700
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License Number State | NJ
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