Individual
CLINTON H IVES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
835 BELMAR PLZ, BELMAR, NJ 07719-2752
(732) 280-0090
(732) 280-0057
Mailing address
835 BELMAR PLZ, BELMAR, NJ 07719-2752
(732) 280-0090
(732) 280-0057
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI00973600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26-2867643
FEDERAL TAX ID
NJ
01
—
9736
LICENSE
NJ
Enumeration date
11/20/2006
Last updated
08/06/2013
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