Provider Demographics
NPI:1386728061
Name:RISPOLI, PHILIP ANTHONY JR (DMD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:ANTHONY
Last Name:RISPOLI
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:1037 US HIGHWAY 46
Mailing Address - Street 2:SUITE CG-1
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2451
Mailing Address - Country:US
Mailing Address - Phone:973-473-4371
Mailing Address - Fax:973-473-2017
Practice Address - Street 1:1037 US HIGHWAY 46
Practice Address - Street 2:SUITE CG-1
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2451
Practice Address - Country:US
Practice Address - Phone:973-473-4371
Practice Address - Fax:973-473-2017
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJDI187771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice