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General NPI Number Information
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NPI Number | 1265578850
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Entity Type | Organization
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Legal Business Name | AFFILIATED ORAL SURGERY GROUP,PC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1113 HOSPITAL DR SUITE 300
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City | WILLINGBORO
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State | NJ
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Zip | 08046-1103
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Country | US
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Telephone | 609-877-2030
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Fax | 609-877-6872
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Provider Business Mailing Address
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Address Line | 1113 HOSPITAL DR SUITE 300
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City | WILLINGBORO
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State | NJ
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Zip | 08046-1103
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Country | US
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Telephone | 609-877-2030
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Fax | 609-877-6872
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH P. FOCARILE
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Credential | D.M.D.
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Telephone | 609-877-2030
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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 | 15562
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License Number State | NJ
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