MEDICARE: DR. WILLIAM LEVATINO D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	10930	NJ

General Provider Information

NPI Number	:	1073621207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM LEVATINO D.M.D.

Provider Business Mailing Address
First Line	:	22 JACKSON AVE
Second Line	:	SUITE A
City	:	POMPTON PLAINS
State	:	NJ
Zip	:	07444-1447
Country	:	US
Telephone Number	:	973-839-4122
Fax Number	:	973-839-3126

Provider Business Practice Location Address
First Line	:	22 JACKSON AVE
Second Line	:	SUITE A
City	:	POMPTON PLAINS
State	:	NJ
Zip	:	07444-1447
Country	:	US
Telephone Number	:	973-839-4122
Fax Number	:	973-839-3126

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	03/07/2023

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