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General NPI Number Information
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NPI Number | 1265644256
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Entity Type | Individual
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Provider Name | STEPHEN TABORI D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 171 MAIN STEET SUITE 4
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City | SOUTH RIVER
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State | NJ
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Zip | 08882
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Country | US
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Telephone | 732-698-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 67 RIEDER RD
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City | SPOTSWOOD
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State | NJ
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Zip | 08884
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Country | US
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Telephone | 732-251-0313
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DI 21259
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License Number State | NJ
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