Organization
SOUTH JERSEY ORAL & MAXILLOFACIAL SURGEONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMERIGO FEDELI DMD (DOCTOR)
(609) 654-1300
Entity
Organization
Contact information
Practice address
135 JACKSON RD, SUITE A, MEDFORD, NJ 08055-9231
(609) 654-1300
(609) 654-0040
Mailing address
135 JACKSON RD, SUITE A, MEDFORD, NJ 08055-9231
(609) 654-1300
(609) 654-0040
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
1223X0008X
Oral and Maxillofacial Radiology Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7945108
—
NJ
Enumeration date
07/25/2006
Last updated
06/30/2008
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