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General NPI Number Information
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NPI Number | 1255743159
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Entity Type | Individual
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Provider Name | DAVID SERRATELLI D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/27/2014
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 125 RIVER RD STE 104
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City | EDGEWATER
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State | NJ
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Zip | 07020-1002
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Country | US
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Telephone | 201-941-0088
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Fax |
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Provider Business Mailing Address
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Address Line | 27 CHESTERFIELD DR
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City | WARREN
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State | NJ
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Zip | 07059-6774
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Country | US
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Telephone |
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Fax |
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 07007
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02593600
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 22DA00799
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License Number State | NJ
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