# LACJR FACIAL SURGERY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cardoso Cosmetic Center for Facial Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497532733
- **Authorized official:** DR. LUCIO ANTONIO CARDOSO JR. DDS, MD (OWNER/ ORAL & MAXILLOFACIAL SURGEON)
- **Authorized official phone:** (973) 943-2245

## Contact information

- **Practice address:** 10 DRS JAMES PARKER BLVD STE 101, RED BANK, NJ 07701-1500
- **Practice address phone:** (973) 943-2245
- **Mailing address:** 10 DRS JAMES PARKER BLVD STE 101, RED BANK, NJ 07701-1500
- **Mailing address phone:** (732) 426-0552
- **Mailing address fax:** (732) 426-0553

## 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:** 09/11/2023
- **Last updated:** 09/21/2024