Provider Demographics
NPI:1992723860
Name:AMNON FAKTOR DDS & DAVE I. FAKTOR DDS
Entity type:Organization
Organization Name:AMNON FAKTOR DDS & DAVE I. FAKTOR DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:I
Authorized Official - Last Name:FAKTOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-431-2080
Mailing Address - Street 1:16 PLAZA 9
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3010
Mailing Address - Country:US
Mailing Address - Phone:732-431-2080
Mailing Address - Fax:
Practice Address - Street 1:16 PLAZA 9
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3010
Practice Address - Country:US
Practice Address - Phone:732-431-2080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty