| Royal Oral & Maxillofacial Surgery | |
|
15 2nd Ave Denville NJ 07834-2711 | |
| (973) 625-4048 | |
| (973) 625-1984 |
| Full Name | Royal Oral & Maxillofacial Surgery |
|---|---|
| Speciality | Dentist |
| Location | 15 2nd Ave, Denville, New Jersey |
| Authorized Official Name and Position | Imad Tamimi (MANAGER) |
| Authorized Official Contact | 9736254048 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Royal Oral & Maxillofacial Surgery 15 2nd Ave Denville NJ 07834-2711 Ph: (973) 625-4048 | Royal Oral & Maxillofacial Surgery 15 2nd Ave Denville NJ 07834-2711 Ph: (973) 625-4048 |
| NPI Number | 1205229895 |
|---|---|
| Provider Enumeration Date | 03/06/2015 |
| Last Update Date | 03/06/2015 |
| Medicare PECOS PAC ID | 2567782634 |
|---|---|
| Medicare Enrollment ID | O20150514000116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205229895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 22DI01875004 (New Jersey) | Primary |
| Provider Name | Imad Tamimi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1659669091 PECOS PAC ID: 0042116618 Enrollment ID: I20110912000111 |
| Provider Name | Mohamed A Boukheir |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1518351964 PECOS PAC ID: 1254624737 Enrollment ID: I20200611000098 |
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