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General NPI Number Information
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NPI Number | 1417818626
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Entity Type | Organization
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Legal Business Name | DICKERSON ORAL SURGERY LLC
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Dates
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Enumeration Date | 11/19/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 80 DOVER CHESTER RD
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City | RANDOLPH
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State | NJ
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Zip | 07869-1209
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Country | US
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Telephone | 973-366-8338
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Fax |
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Provider Business Mailing Address
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Address Line | 80 DOVER CHESTER RD
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City | RANDOLPH
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State | NJ
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Zip | 07869-1209
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERIK DICKERSON
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Credential | DDS MS
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Telephone | 973-703-7817
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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 |
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License Number State |
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