Provider Demographics
NPI:1154918910
Name:MIDJERSEY FAMILY & IMPLANT DENTISTRY
Entity type:Organization
Organization Name:MIDJERSEY FAMILY & IMPLANT DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ELMORSHEDY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-307-1718
Mailing Address - Street 1:107 CEDAR GROVE LN STE 102
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4719
Mailing Address - Country:US
Mailing Address - Phone:732-357-3770
Mailing Address - Fax:
Practice Address - Street 1:107 CEDAR GROVE LN STE 102
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-4719
Practice Address - Country:US
Practice Address - Phone:732-357-3770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental