Organization
AESTHETIC ORAL & MAXILLOFACIAL SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS A CHIODO DDS (DOCTOR)
(201) 921-4687
Entity
Organization
Contact information
Practice address
348 E MAIN ST, SOMERVILLE, NJ 08876-3110
(908) 722-0850
Mailing address
52 INDEPENDENCE WAY, JERSEY CITY, NJ 07305-5460
(201) 921-4687
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
22DI020953
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770587230
INDIVIDUAL NPI DR. CHIODO
NJ
Enumeration date
07/03/2007
Last updated
10/22/2007
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