Organization
EASTERN DENTAL OF OCEAN/MONMOUTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA MUCCIARIELLO (CREDENTIALING SPECIALIST)
(732) 750-0707
Entity
Organization
Contact information
Practice address
2770 HOOPER AVE., UNIT 4, BRICK, NJ 08723
(732) 477-9200
Mailing address
2770 HOOPER AVE., UNIT 4, BRICK, NJ 08723
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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