Provider Demographics
NPI:1154596641
Name:MOLINO, JOSEPH CHARLES (DDS)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:CHARLES
Last Name:MOLINO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 ERNSTON RD
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-1701
Mailing Address - Country:US
Mailing Address - Phone:732-727-9310
Mailing Address - Fax:732-727-9310
Practice Address - Street 1:21 ERNSTON RD
Practice Address - Street 2:
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-1701
Practice Address - Country:US
Practice Address - Phone:732-727-9310
Practice Address - Fax:732-727-9310
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI010033001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice