# EASTERN DENTAL OF OCEAN/MONMOUTH, LLC

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

## Provider details

- **NPI number:** 1780130377
- **Authorized official:** AMANDA MUCCIARIELLO (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (732) 750-0707

## Contact information

- **Practice address:** 2770 HOOPER AVE., UNIT 4, BRICK, NJ 08723
- **Practice address phone:** (732) 477-9200
- **Mailing address:** 2770 HOOPER AVE., UNIT 4, BRICK, NJ 08723

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 09/01/2016
- **Last updated:** 09/01/2016