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General NPI Number Information
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NPI Number | 1902396716
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Entity Type | Individual
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Provider Name | PETER K HENEIN DMD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2018
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Last Update Date | 07/23/2023
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Provider Practice Location Address
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Address Line | 1125 HIGHWAY 35
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City | OCEAN
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State | NJ
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Zip | 07712-4043
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Country | US
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Telephone | 732-531-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 200 HOLLISTER AVE
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City | RUTHERFORD
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State | NJ
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Zip | 07070-1907
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Country | US
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Telephone | 201-314-2105
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Fax |
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 22DI02744100
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License Number State | NJ
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