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General NPI Number Information
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NPI Number | 1801772009
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Entity Type | Organization
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Legal Business Name | MICHAEL DEPAOLO, DMD, LLC
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 191 BROAD ST
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City | RED BANK
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State | NJ
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Zip | 07701-2048
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Country | US
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Telephone | 908-868-2619
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Fax |
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Provider Business Mailing Address
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Address Line | 55 JONESDALE AVE
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City | METUCHEN
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State | NJ
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Zip | 08840-2028
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Country | US
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Telephone | 908-868-2619
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL DEPAOLO
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Credential | DMD
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Telephone | 908-868-2619
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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 |
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License Number State |
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