Organization
DENISE DIBONA DDS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE DIBONA DDS (DENTIST/OWNER)
(732) 530-5111
Entity
Organization
Contact information
Practice address
146 MAPLE AVE, RED BANK, NJ 07701-1701
(732) 530-5111
(732) 741-2584
Mailing address
146 MAPLE AVE, RED BANK, NJ 07701-1701
(732) 530-5111
(732) 741-2584
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI15880
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DI15880
NJ STATE DENTAL LICENSE
NJ
Enumeration date
10/24/2007
Last updated
04/10/2019
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