Provider Demographics
NPI:1215086590
Name:SHOMER, DANIEL C (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:C
Last Name:SHOMER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 CEDAR GROVE RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-5547
Mailing Address - Country:US
Mailing Address - Phone:732-240-2222
Mailing Address - Fax:
Practice Address - Street 1:42 CEDAR GROVE RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-5547
Practice Address - Country:US
Practice Address - Phone:732-240-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ150441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice