Individual
DR. JUSTIN CHARLES PONQUINETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
970 CLIFTON AVE, SECOND FLOOR, CLIFTON, NJ 07013-2731
(973) 473-3100
Mailing address
126 DEEPWATER CIR, MANALAPAN, NJ 07726-4148
(718) 704-3037
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22DI02369900
NJ
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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