Provider Demographics
NPI:1588689426
Name:THE DENTISTS OF WOODBRIDGE
Entity type:Organization
Organization Name:THE DENTISTS OF WOODBRIDGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JABLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-636-3434
Mailing Address - Street 1:424 AMBOY AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-2983
Mailing Address - Country:US
Mailing Address - Phone:732-636-3434
Mailing Address - Fax:
Practice Address - Street 1:424 AMBOY AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-2913
Practice Address - Country:US
Practice Address - Phone:732-636-3434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI157041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty