| Shore Oral And Maxillofacial Surgery, Llc | |
| 
					54 W Jimmie Leeds Rd Suite 6 Galloway NJ 08205-9438  | |
| (609) 748-9600 | |
| (609) 748-9611 | 
| Full Name | Shore Oral And Maxillofacial Surgery, Llc | 
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery | 
| Location | 54 W Jimmie Leeds Rd, Galloway, New Jersey | 
| Authorized Official Name and Position | Boris Kalika (OWNER) | 
| Authorized Official Contact | 6097489600 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Shore Oral And Maxillofacial Surgery, Llc 54 W Jimmie Leeds Rd Suite 6 Galloway NJ 08205-9438 Ph: (609) 748-9600  | Shore Oral And Maxillofacial Surgery, Llc 54 W Jimmie Leeds Rd Suite 6 Galloway NJ 08205-9438 Ph: (609) 748-9600  | 
| NPI Number | 1952680100 | 
|---|---|
| Provider Enumeration Date | 08/05/2011 | 
| Last Update Date | 10/18/2011 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1952680100 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 22DI02243200 (New Jersey) | Primary | 
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