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General NPI Number Information
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NPI Number | 1649328766
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Entity Type | Individual
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Provider Name | PETER WILLIAM DAMKEN DDS
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Gender | Male
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 185 CENTER AVE
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City | WESTWOOD
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State | NJ
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Zip | 07675-2237
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Country | US
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Telephone | 201-664-0409
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Fax | 201-664-4895
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Provider Business Mailing Address
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Address Line | 40 BEAKES AVE
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City | MIDDLETOWN
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State | NY
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Zip | 10940-4304
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Country | US
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Telephone | 845-344-4780
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Fax | 201-664-4895
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 13233
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License Number State | NJ
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