Organization
CHANTILLY DENTAL GROUP LLC
Active
Other names
Monmouth DEntal Group North
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID E. TARRAB DDS (MANAGING MEMBER)
(732) 888-7770
Entity
Organization
Contact information
Practice address
1 STATE ROUTE 35, KEYPORT, NJ 07735-1128
(732) 888-7770
(732) 888-2711
Mailing address
1 STATE ROUTE 35, KEYPORT, NJ 07735-1128
(732) 888-7770
(732) 888-2711
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DI01693000
NJ
Other
Enumeration date
05/21/2007
Last updated
08/22/2020
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