| New Jersey Center For Oral & Maxillofacial Surgery | |
|
949 Spring Valley Rd Maywood NJ 07607-1452 | |
| (201) 712-5556 | |
| (201) 712-9190 |
| Full Name | New Jersey Center For Oral & Maxillofacial Surgery |
|---|---|
| Speciality | Oral & Maxillofacial Surgery |
| Location | 949 Spring Valley Rd, Maywood, New Jersey |
| Authorized Official Name and Position | Michael Costello (OWNER) |
| Authorized Official Contact | 2017125556 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Jersey Center For Oral & Maxillofacial Surgery 949 Spring Valley Rd Maywood NJ 07607-1452 Ph: (201) 712-5556 | New Jersey Center For Oral & Maxillofacial Surgery 949 Spring Valley Rd Maywood NJ 07607-1452 Ph: (201) 712-5556 |
| NPI Number | 1619221827 |
|---|---|
| Provider Enumeration Date | 11/09/2012 |
| Last Update Date | 09/15/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619221827 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DI19847 (New Jersey) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | DI19847 (New Jersey) | Primary |
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