# CENTRAL JERSEY ORAL AND MAXILLOFACIAL SURGERY,P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164596268
- **Authorized official:** DR. LAURENCE DAVID SUSSMAN D.D.S. (V. PRES)
- **Authorized official phone:** (732) 566-7648

## Contact information

- **Practice address:** 158 MAIN ST, MATAWAN, NJ 07747-4104
- **Practice address phone:** (732) 566-7648
- **Practice address fax:** (732) 566-1919
- **Mailing address:** 158 MAIN ST, MATAWAN, NJ 07747-4104
- **Mailing address phone:** (732) 566-7648
- **Mailing address fax:** (732) 566-1919

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 11/20/2006
- **Last updated:** 06/24/2008