Organization
COASTAL DENTAL GROUP SOUTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH RICHARD ZICCHINO D.D.S. (OWNER/DENTIST)
(732) 714-1030
Entity
Organization
Contact information
Practice address
2407 BRIDGE AVE, POINT PLEASANT BORO, NJ 08742-4334
(732) 714-1030
Mailing address
2407 BRIDGE AVE, POINT PLEASANT BORO, NJ 08742-4334
(732) 714-1030
(732) 714-1142
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02008701
NJ
Other
Enumeration date
08/18/2015
Last updated
08/18/2015
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