# SHORE ORAL AND MAXILLOFACIAL SURGERY, LLC

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

## Provider details

- **NPI number:** 1952680100
- **Authorized official:** DR. BORIS KALIKA DMD (OWNER)
- **Authorized official phone:** (609) 748-9600

## Contact information

- **Practice address:** 54 W JIMMIE LEEDS RD, SUITE 6, GALLOWAY, NJ 08205-9438
- **Practice address phone:** (609) 748-9600
- **Practice address fax:** (609) 748-9611
- **Mailing address:** 54 W JIMMIE LEEDS RD, SUITE 6, GALLOWAY, NJ 08205-9438
- **Mailing address phone:** (609) 748-9600
- **Mailing address fax:** (609) 748-9611

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 22DI02243200 | NJ | Yes |

## Other

- **Enumeration date:** 08/05/2011
- **Last updated:** 10/18/2011