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NPI Code Detail

MEDICARE: EGG HARBOR FAMILY DENTAL, PA

MEDICARE: EGG HARBOR FAMILY DENTAL, PA
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
1122300000XDentist

General Provider Information

NPI Number : 1104880863
Entity Type Code : Organization
Provider Name (Legal Business Name) : EGG HARBOR FAMILY DENTAL, PA
Provider Business Mailing Address
First Line : 16 WASHINGTON ST
Second Line :
City : TOMS RIVER
State : NJ
Zip : 08753-7643
Country : US
Telephone Number : 732-914-1039
Fax Number :
Provider Business Practice Location Address
First Line : 3003 ENGLISH CREEK AVE
Second Line : D-11
City : EGG HARBOR TOWNSHIP
State : NJ
Zip : 08234-4863
Country : US
Telephone Number : 609-484-5996
Fax Number :
Authorized Official
Title or Position : OWNER
Name : STEPHEN ABBATICCHIO
Credential : DDS
Telephone Number : 732-553-9393
Provider Enumeration Date : 04/12/2006
Last Update Date : 02/20/2019

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Directions to “EGG HARBOR FAMILY DENTAL, PA ” Practice Location

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