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General NPI Number Information
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NPI Number | 1558579086
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Entity Type | Organization
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Legal Business Name | ISAACSONORTHODONTICS,L.L.P.
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 103 PARKER ROAD
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City | WEST LONG BRANCH
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State | NJ
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Zip | 07764
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Country | US
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Telephone | 732-870-8077
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Fax |
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Provider Business Mailing Address
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Address Line | 532 CEDAR AVE
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City | WEST LONG BRANCH
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State | NJ
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Zip | 07764-1758
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Country | US
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Telephone | 732-222-1294
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. RICHARD DEAN ISAACSON
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Credential | D.M.D.
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Telephone | 732-870-8077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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