Organization
ORAL AND MAXILLOFACIAL SURGERY AND IMPLANT SPECIALISTS OF MIDDLESEX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL KEITH GOULSTON DMD, MD (OWNER)
(908) 222-0040
Entity
Organization
Contact information
Practice address
295 DURHAM AVE, SUITE 213, SOUTH PLAINFIELD, NJ 07080-2548
(908) 222-0040
(908) 222-0041
Mailing address
295 DURHAM AVE, SUITE 213, SOUTH PLAINFIELD, NJ 07080-2548
(908) 222-0040
(908) 222-0041
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
22DI02509200
NJ
Other
Enumeration date
09/18/2014
Last updated
01/09/2015
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