Organization
JP ORAL SURGERY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN CHARLES PONQUINETTE DMD (OWNER)
(732) 747-0993
Entity
Organization
Contact information
Practice address
21 N GILBERT ST, SUITE 210, TINTON FALLS, NJ 07701-4950
(732) 747-0993
Mailing address
21 N GILBERT ST, SUITE 210, TINTON FALLS, NJ 07701-4950
(732) 747-0993
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
0400696228
NJ
Other
Enumeration date
03/31/2016
Last updated
03/31/2016
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