Organization
IN-HOUSE DENTAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THERESA DANTONIO DDS (DENTIST/OWNER)
(732) 363-1411
Entity
Organization
Contact information
Practice address
975 BENNETTS MILLS RD, JACKSON, NJ 08527-2225
(732) 363-1411
(732) 363-1401
Mailing address
24 LEONE BLVD, JACKSON, NJ 08527
(732) 363-1411
(732) 363-1401
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
DI02081701
NJ
310400000X
Assisted Living Facility
Primary
DI19441
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0047899
—
NJ
05
—
0047911
—
NJ
Enumeration date
03/31/2010
Last updated
03/31/2010
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