Organization
NEW JERSEY MOBILE DENTAL PRACTICE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN A BEUKAS D.M.D. (PRESIDENT)
(732) 431-7577
Entity
Organization
Contact information
Practice address
24 MERCHANTS WAY, COLTS NECK, NJ 07722-1570
(732) 431-7577
(732) 431-8070
Mailing address
637 WYCKOFF AVE, SUITE 236, WYCKOFF, NJ 07481-1438
(732) 431-7577
(732) 431-8070
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DI018346
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6516301
—
NJ
Enumeration date
03/27/2007
Last updated
08/22/2020
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