Provider Demographics
NPI:1104322957
Name:JOBELLA DENTAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:JOBELLA DENTAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:347-385-3593
Mailing Address - Street 1:6 TRUDY LN
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4676
Mailing Address - Country:US
Mailing Address - Phone:347-385-3593
Mailing Address - Fax:
Practice Address - Street 1:1115 ARNOLD AVE
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-2384
Practice Address - Country:US
Practice Address - Phone:732-899-3363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02679800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty