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General NPI Number Information
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NPI Number | 1235406950
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Entity Type | Organization
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Legal Business Name | DEMAIO-RUTNER ORAL & MAXILLOFACIAL SURGERY ASSOCIATES. LLC
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Dates
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Enumeration Date | 11/23/2011
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Last Update Date | 11/23/2011
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Provider Practice Location Address
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Address Line | 590 WESTFIELD AVE
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City | WESTFIELD
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State | NJ
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Zip | 07090-3312
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Country | US
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Telephone | 908-654-6030
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Fax | 908-654-8160
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Provider Business Mailing Address
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Address Line | 590 WESTFIELD AVE
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City | WESTFIELD
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State | NJ
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Zip | 07090-3312
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Country | US
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Telephone | 908-654-6030
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Fax | 908-654-8160
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Authorized Official
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Title or Position | PARTNER
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Name | DR. JOSEPH DENNIS DEMAIO
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Credential | DDS
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Telephone | 908-654-6030
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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 | 10693
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License Number State | NJ
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