Provider Demographics
NPI:1215120472
Name:DLUGOSZ, MICHELLE (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:DLUGOSZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 MONMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1536
Mailing Address - Country:US
Mailing Address - Phone:732-776-9559
Mailing Address - Fax:732-776-9501
Practice Address - Street 1:226 MONMOUTH RD
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1536
Practice Address - Country:US
Practice Address - Phone:732-776-9559
Practice Address - Fax:732-776-9501
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ221011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice