Organization
NEW JERSEY MAXILLOFACIAL DIGITAL IMAGING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY E OLIVERIE DMD (MEMBER)
(732) 681-5544
Entity
Organization
Contact information
Practice address
1516 HWY 138, WALL, NJ 07719-3700
(732) 681-5544
Mailing address
1516 HWY 138, WALL, NJ 07719-3700
(732) 681-5544
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
DI20496
NJ
Other
Enumeration date
11/05/2010
Last updated
11/05/2010
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