MEDICARE: PRECISION DENTAL GROUP PC

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	1223P0300X	Periodontics

General Provider Information

NPI Number	:	1235717901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION DENTAL GROUP PC

Provider Business Mailing Address
First Line	:	491 AMWELL RD STE 204
Second Line	:
City	:	HILLSBOROUGH
State	:	NJ
Zip	:	08844-8212
Country	:	US
Telephone Number	:	908-431-0000
Fax Number	:	908-431-0007

Provider Business Practice Location Address
First Line	:	491 AMWELL RD STE 204
Second Line	:
City	:	HILLSBOROUGH
State	:	NJ
Zip	:	08844-8212
Country	:	US
Telephone Number	:	908-431-0000
Fax Number	:	908-431-0007

Authorized Official
Title or Position	:	ASSOCIATE
Name	:	CHRISTINE WONG
Credential	:
Telephone Number	:	713-885-7842

Provider Enumeration Date	:	04/01/2021
Last Update Date	:	03/02/2026

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