Organization
LINCROFT ORAL AND MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN FRATTELLONE DMD (OWNER)
(732) 842-5915
Entity
Organization
Contact information
Practice address
515 NEWMAN SPRINGS RD, LINCROFT, NJ 07738-1426
(732) 842-5915
(732) 842-5910
Mailing address
515 NEWMAN SPRINGS RD, LINCROFT, NJ 07738-1426
(732) 842-5915
(732) 842-5910
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
16514
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6009409
—
NJ
Enumeration date
02/23/2007
Last updated
12/23/2013
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