Individual
JOHN WILLIAM VITALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
388 LAKEHURST RD, TOMS RIVER, NJ 08755-7340
(732) 240-6616
Mailing address
388 LAKEHURST RD, TOMS RIVER, NJ 08755-7340
(732) 240-6616
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
22DI01153300
NJ
Other
Enumeration date
10/20/2006
Last updated
12/13/2007
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