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General NPI Number Information
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NPI Number | 1386793081
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Entity Type | Organization
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Legal Business Name | ELLIOT M. ALTMAN, DDS & VICTOR J. BUCCELLATO,DMD,PA
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 507 STILLWELLS CORNER RD. STE D
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City | FREEHOLD
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State | NJ
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Zip | 07728
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Country | US
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Telephone | 732-462-0021
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Fax | 732-462-1602
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Provider Business Mailing Address
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Address Line | 507 STILLWELLS CORNER RD. STE D
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City | FREEHOLD
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State | NJ
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Zip | 07728
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Country | US
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Telephone | 732-462-0021
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Fax | 732-462-1602
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Authorized Official
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Title or Position | OFFICE MGR.
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Name | MRS. NANCY D BRUNO
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Credential |
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Telephone | 732-462-0021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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