MEDICARE: DR. JACQUELINE MILONE 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	122300000X	Dentist	2DI02800500	NJ

General Provider Information

NPI Number	:	1518383900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUELINE MILONE D.M.D.

Provider Business Mailing Address
First Line	:	245 CRABTREE CT
Second Line	:
City	:	BASKING RIDGE
State	:	NJ
Zip	:	07920-3153
Country	:	US
Telephone Number	:	412-601-1633
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 EWING ST STE B4
Second Line	:
City	:	PRINCETON
State	:	NJ
Zip	:	08540-2755
Country	:	US
Telephone Number	:	609-924-1975
Fax Number	:

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

Provider Enumeration Date	:	03/10/2014
Last Update Date	:	10/01/2020

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