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General NPI Number Information
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NPI Number | 1770617797
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Entity Type | Organization
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Legal Business Name | JOSEPH M MICALE DMD PA
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12 RIDGE ST
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-1760
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Country | US
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Telephone | 908-766-1515
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Fax | 908-766-6710
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Provider Business Mailing Address
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Address Line | 12 RIDGE ST
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-1760
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Country | US
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Telephone | 908-766-1515
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Fax | 908-766-6710
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH M MICALE
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Credential | DMD
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Telephone | 908-766-1515
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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 | 22DI01665700
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License Number State | NJ
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