MEDICARE: DIAMOND BEACH DENTAL

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	122300000X	Dentist	DI12756	NJ

General Provider Information

NPI Number	:	1225563877
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIAMOND BEACH DENTAL

Provider Business Mailing Address
First Line	:	9850 PACIFIC AVE
Second Line	:
City	:	WILDWOOD CREST
State	:	NJ
Zip	:	08260-3213
Country	:	US
Telephone Number	:	609-522-3145
Fax Number	:	609-522-9008

Provider Business Practice Location Address
First Line	:	9850 PACIFIC AVE
Second Line	:
City	:	WILDWOOD CREST
State	:	NJ
Zip	:	08260-3213
Country	:	US
Telephone Number	:	609-522-3145
Fax Number	:	609-522-9008

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SCOTT MASLOW
Credential	:	DMD
Telephone Number	:	609-522-3145

Provider Enumeration Date	:	04/20/2017
Last Update Date	:	04/20/2017

Similar Medicare Providers

1831271659 — DR. SCOTT MASLOW DMD
Practice Location Address:

9850 PACIFIC AVE
WILDWOOD CREST, NJ
08260-3213

Practice Phone: 609-522-3145
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1336146695 — DR. BENNETT J SHATKIN MD
Practice Location Address:

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1295798262 — MICHAEL S. KOCINSKI D.O.
Practice Location Address:

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1922013366 — BOROUGH OF WILDWOOD CREST
Practice Location Address:

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Practice Fax:

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