# MATAWAN/OLD BRIDGE DENTAL, PA

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

## Provider details

- **NPI number:** 1295920098
- **Authorized official:** DR. DENNIS MICHAEL KELLER D.M.D. (OWNER)
- **Authorized official phone:** (732) 566-3111

## Contact information

- **Practice address:** 349H MATAWAN RD, MATAWAN, NJ 07747-3929
- **Practice address phone:** (732) 566-3111
- **Practice address fax:** (732) 566-6308
- **Mailing address:** 349H MATAWAN RD, MATAWAN, NJ 07747-3929
- **Mailing address phone:** (732) 566-3111
- **Mailing address fax:** (732) 566-6308

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 09859 | NJ | Yes |

## Other

- **Enumeration date:** 09/14/2007
- **Last updated:** 09/11/2008