| Chantilly Dental Group Llc | |
|
1 State Route 35 Keyport NJ 07735-1128 | |
| (732) 888-7770 | |
| (732) 888-2711 |
| Full Name | Chantilly Dental Group Llc |
|---|---|
| Speciality | Dentist |
| Location | 1 State Route 35, Keyport, New Jersey |
| Authorized Official Name and Position | David E. Tarrab (MANAGING MEMBER) |
| Authorized Official Contact | 7328887770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chantilly Dental Group Llc 1 State Route 35 Keyport NJ 07735-1128 Ph: (732) 888-7770 | Chantilly Dental Group Llc 1 State Route 35 Keyport NJ 07735-1128 Ph: (732) 888-7770 |
| NPI Number | 1629287412 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629287412 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DI01693000 (New Jersey) | Primary |
Family Dentistry Of Keyport Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 45 Maple Pl, Keyport, NJ 07735 Phone: 732-246-9411 |