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General NPI Number Information
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NPI Number | 1720212590
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Entity Type | Organization
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Legal Business Name | ALLIANCE ORAL SURGERY
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Dates
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Enumeration Date | 05/08/2009
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Last Update Date | 12/31/2013
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Provider Practice Location Address
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Address Line | 1301 ROUTE 72 W SUITE 220
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City | MANAHAWKIN
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State | NJ
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Zip | 08050-2483
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Country | US
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Telephone | 609-597-9600
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Fax | 732-842-5910
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Provider Business Mailing Address
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Address Line | 515 NEWMAN SPRINGS RD
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City | LINCROFT
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State | NJ
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Zip | 07738-1426
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Country | US
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Telephone | 732-842-5915
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Fax | 732-842-5910
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN FRATTELLONE
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Credential | DMD
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Telephone | 732-842-5915
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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 | NJ
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