Provider Demographics
NPI:1316467491
Name:OLDWICK COSMETIC & FAMILY DENTISTRY - OLDWICK
Entity type:Organization
Organization Name:OLDWICK COSMETIC & FAMILY DENTISTRY - OLDWICK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-750-0707
Mailing Address - Street 1:53 OLD TURNPIKE ROAD
Mailing Address - Street 2:
Mailing Address - City:OLDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08858
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:53 OLD TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:OLDWICK
Practice Address - State:NJ
Practice Address - Zip Code:08858
Practice Address - Country:US
Practice Address - Phone:908-439-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-21
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty