Organization
KEYPORT DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH RICHARD ZICCHINO DDS (OWNER)
(732) 714-1030
Entity
Organization
Contact information
Practice address
2407 BRIDGE AVE, POINT PLEASANT BORO, NJ 08742-4334
(732) 714-1030
(732) 714-1142
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
DI20087
NJ
Other
Enumeration date
03/08/2012
Last updated
03/08/2012
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