Individual
DR. JOSEPH ALBERT BASILICATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
191 HAMBURG TPKE, POMPTON LAKES, NJ 07442-2330
(973) 831-0109
Mailing address
34 WHEELER RD, WAYNE, NJ 07470-8206
(973) 872-1174
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22DI02266200
NJ
Other
Enumeration date
11/06/2006
Last updated
07/08/2007
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