Individual
PHILIP JOSEPH TAVERNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
250 HECKMAN ST, PHILLIPSBURG, NJ 08865-3208
(908) 454-0977
Mailing address
PO BOX 5114, PHILLIPSBURG, NJ 08865-5114
(908) 454-0977
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22D101103100
NJ
Other
Enumeration date
04/14/2008
Last updated
04/14/2008
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