MEDICARE: DRUM POINT FAMILY & IMPLANT DENTISTRY 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	1223G0001X	General Practice Dentistry	22DI02257001	NJ

General Provider Information

NPI Number	:	1689942922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRUM POINT FAMILY & IMPLANT DENTISTRY PC

Provider Business Mailing Address
First Line	:	131 DRUM POINT RD
Second Line	:
City	:	BRICK
State	:	NJ
Zip	:	08723-6221
Country	:	US
Telephone Number	:	732-451-0400
Fax Number	:	732-451-0500

Provider Business Practice Location Address
First Line	:	131 DRUM POINT RD
Second Line	:
City	:	BRICK
State	:	NJ
Zip	:	08723-6221
Country	:	US
Telephone Number	:	732-451-0400
Fax Number	:	732-451-0500

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	EVELYN BONIAKOWSKI
Credential	:	RDA, CDA
Telephone Number	:	732-238-6660

Provider Enumeration Date	:	12/01/2011
Last Update Date	:	01/21/2016

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