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General NPI Number Information
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NPI Number | 1396868154
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Entity Type | Organization
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Legal Business Name | MARLBORO DENTAL ARTS
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 242 STATE ROUTE 79 N SUITE 7
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City | MORGANVILLE
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State | NJ
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Zip | 07751-2078
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Country | US
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Telephone | 732-817-1100
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Fax | 732-817-1102
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Provider Business Mailing Address
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Address Line | 242 STATE ROUTE 79 N SUITE 7
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City | MORGANVILLE
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State | NJ
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Zip | 07751
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Country | US
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Telephone | 732-817-1100
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Fax | 732-817-1102
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHEN ABBATICCHIO
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Credential | D.D.S.
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Telephone | 732-817-1100
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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 | DI02239800
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License Number State | NJ
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