# ATLANTIC ENT GROUP LLC

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

## Provider details

- **NPI number:** 1629294079
- **Authorized official:** DR. ANTHONY DEGENNARO MD (PRESIDENT)
- **Authorized official phone:** (732) 530-7799

## Contact information

- **Practice address:** 370 STATE HIGHWAY 35, SUITE 100, RED BANK, NJ 07701
- **Practice address phone:** (732) 530-7799
- **Practice address fax:** (732) 530-9091
- **Mailing address:** 370 STATE HIGHWAY 35, SUITE 100, RED BANK, NJ 07701
- **Mailing address phone:** (732) 530-7799
- **Mailing address fax:** (732) 530-9091

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | NULL | Yes |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/17/2007
- **Last updated:** 08/22/2020