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General NPI Number Information
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NPI Number | 1396101333
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Entity Type | Organization
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Legal Business Name | DAYTON DENTAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 01/06/2016
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Last Update Date | 01/06/2016
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Provider Practice Location Address
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Address Line | 338 GEORGES RD
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City | DAYTON
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State | NJ
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Zip | 08810-1546
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Country | US
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Telephone | 732-329-3113
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Fax | 732-329-2889
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Provider Business Mailing Address
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Address Line | 338 GEORGES RD
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City | DAYTON
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State | NJ
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Zip | 08810-1546
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Country | US
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Telephone | 732-329-3113
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Fax | 732-329-2889
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Authorized Official
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Title or Position | CEO
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Name | DR. LOUIS ANTHONY D'ANGELO
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Credential | DMD
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Telephone | 215-816-5408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 22HI0046500
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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 | 22DIO1469400
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License Number State | NJ
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