Organization
NORTHEAST FACIAL AND ORAL SURGERY SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGG A JACOB DMD (OWNER)
(973) 360-1100
Entity
Organization
Contact information
Practice address
83 HANOVER RD STE 240, FLORHAM PARK, NJ 07932-1508
(973) 360-1100
(973) 360-1101
Mailing address
83 HANOVER RD STE 240, FLORHAM PARK, NJ 07932-1508
(973) 360-1100
(973) 360-1101
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22DI02252800
NJ
Other
Enumeration date
09/13/2017
Last updated
07/21/2022
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