MEDICARE: AC DENTAL OF TOMS RIVER NJ INC

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	261QD0000X	Dental Clinic/Center	22DI02214900	NJ

General Provider Information

NPI Number	:	1275795882
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AC DENTAL OF TOMS RIVER NJ INC

Provider Business Mailing Address
First Line	:	941 RTE 37 W
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-5054
Country	:	US
Telephone Number	:	732-244-1163
Fax Number	:	732-244-1164

Provider Business Practice Location Address
First Line	:	941 RTE 37 W
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-5054
Country	:	US
Telephone Number	:	732-244-1136
Fax Number	:	732-244-1164

Authorized Official
Title or Position	:	DENTIST/OWNER
Name	:	RUNJAN SETH
Credential	:	DMD
Telephone Number	:	732-254-9000

Provider Enumeration Date	:	06/26/2008
Last Update Date	:	06/26/2008

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