MEDICARE: CAPE ATLANTIC ORAL & MAXILLOFACIAL SURGEONS, PA, 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DI09028	NJ

General Provider Information

NPI Number	:	1952356792
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAPE ATLANTIC ORAL & MAXILLOFACIAL SURGEONS, PA, INC

Provider Business Mailing Address
First Line	:	PO BOX 898
Second Line	:
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-0898
Country	:	US
Telephone Number	:	609-465-4340
Fax Number	:	609-465-5064

Provider Business Practice Location Address
First Line	:	101 STONE HARBOR BLVD
Second Line	:
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-2135
Country	:	US
Telephone Number	:	609-465-4340
Fax Number	:	609-465-5064

Authorized Official
Title or Position	:	PRES/OWNER
Name	:	DR. HARVEY C STRAIR
Credential	:	DMD
Telephone Number	:	609-465-4340

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	11/08/2007

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