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Dr. Theodore A Niebloom, DMD
Oral and Maxillofacial Surgery (Dentist) in West Orange, New Jersey
NPI 1689750705

Theodore A Niebloom is a Oral and Maxillofacial Surgery (Dentist) based in West Orange, NJ and is specialized in Oral and Maxillofacial Surgery. Theodore A Niebloom practices in West Orange, NJ and has the professional credentials of DMD. The NPI Number for Theodore A Niebloom is 1689750705 and holds a License No. 22DI01604200 (New Jersey).

The current practice location address for Theodore A Niebloom is 101 Old Short Hills Road, West Orange, NJ and can be reached out via phone at 973-736-7616 and via fax at 973-325-3487.

Location: 101 Old Short Hills Road, West Orange, NJ, 07052
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1689750705
Provider Name
Theodore A Niebloom
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
101 Old Short Hills Road, West Orange, NJ, 07052
Phone Number
973-736-7616
Fax Number
973-325-3487
Provider Enumeration Date
10/31/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
101 Old Short Hills Road
City
West Orange
State
New Jersey
Zip
07052
Phone Number
973-736-7616
Fax Number
973-325-3487
person
Provider Business Mailing Address Details
Address
101 Old Short Hills Road
City
West Orange
State
New Jersey
Zip
07052
Phone Number
973-736-7616
Fax Number
973-325-3487
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
22DI01604200 (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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