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Organization

PROUSI ORAL & FACIAL SURGERY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANTHONY PROUSI DDS, MD (OWNER / SURGEON)
(609) 526-8650
Entity
Organization

Contact information

Practice address
1900 MOUNT HOLLY RD, BUILDING 500, BURLINGTON TOWNSHIP, NJ 08016-4722
(609) 526-8650
(609) 526-8640
Mailing address
1900 MOUNT HOLLY RD, BUILDING 500, BURLINGTON TOWNSHIP, NJ 08016-4722
(609) 526-8650
(609) 526-8640

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22DI02541600
NJ

Other

Enumeration date
02/23/2017
Last updated
02/23/2017
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