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Shore Oral Maxillo Surgery Group Pa
Oral and Maxillofacial Surgery (Dentist) in Lakewood, New Jersey
NPI 1619104015

Shore Oral Maxillo Surgery Group Pa is a Oral and Maxillofacial Surgery (Dentist) based in Lakewood, NJ and is specialized in Oral and Maxillofacial Surgery. Shore Oral Maxillo Surgery Group Pa practices in Lakewood, NJ. The NPI Number for Shore Oral Maxillo Surgery Group Pa is 1619104015 and holds a License No. DI09103 (New Jersey).

The current practice location address for Shore Oral Maxillo Surgery Group Pa is 301 Madison Ave, Lakewood, NJ and can be reached out via phone at 732-367-4042 and via fax at 732-905-9210.

Location: 301 Madison Ave, Lakewood, NJ, 08701-3266
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1619104015
Provider Name
Shore Oral Maxillo Surgery Group Pa
Credential
Provider Entity Type
Organization
Address
301 Madison Ave, Lakewood, NJ, 08701-3266
Phone Number
732-367-4042
Fax Number
732-905-9210
Provider Enumeration Date
06/12/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1642006 05 NJ
institution
Provider Business Practice Location Address Details
Address
301 Madison Ave
City
Lakewood
State
New Jersey
Zip
08701-3266
Phone Number
732-367-4042
Fax Number
732-905-9210
person
Provider Business Mailing Address Details
Address
301 Madison Ave
City
Lakewood
State
New Jersey
Zip
08701-3266
Phone Number
732-367-4042
Fax Number
732-905-9210
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
DI09103 (New Jersey)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
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