Organization
JP ORAL SURGERY ASSOCIATES PC
Active
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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