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NPI Code Detail

MEDICARE: DR. MIRIAM TYGIER FURLONG DMD

MEDICARE: DR. MIRIAM TYGIER FURLONG DMD
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
1122300000XDentist22DI02024800NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
122DI02024800OTHERNJDENTAL LICENSE

General Provider Information

NPI Number : 1841675931
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIRIAM TYGIER FURLONG DMD
Provider Business Mailing Address
First Line : 186 W VETERANS HWY
Second Line :
City : JACKSON
State : NJ
Zip : 08527-3410
Country : US
Telephone Number : 732-942-8400
Fax Number : 732-942-6505
Provider Business Practice Location Address
First Line : 186 W VETERANS HWY
Second Line :
City : JACKSON
State : NJ
Zip : 08527-3410
Country : US
Telephone Number : 732-942-8400
Fax Number : 732-942-6505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2015
Last Update Date : 07/30/2015

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