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Organization
CENTRAL JERSEY ORAL AND MAXILLOFACIAL SURGERY,P.A.
Active
Organization
CENTRAL JERSEY ORAL AND MAXILLOFACIAL SURGERY,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURENCE DAVID SUSSMAN D.D.S. (V. PRES)
(732) 566-7648
Entity
Organization
Contact information
Practice address
158 MAIN ST, MATAWAN, NJ 07747-4104
(732) 566-7648
(732) 566-1919
Mailing address
158 MAIN ST, MATAWAN, NJ 07747-4104
(732) 566-7648
(732) 566-1919
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
11/20/2006
Last updated
06/24/2008
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