Organization
SHORE ORAL AND MAXILLOFACIAL SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BORIS KALIKA DMD (OWNER)
(609) 748-9600
Entity
Organization
Contact information
Practice address
54 W JIMMIE LEEDS RD, SUITE 6, GALLOWAY, NJ 08205-9438
(609) 748-9600
(609) 748-9611
Mailing address
54 W JIMMIE LEEDS RD, SUITE 6, GALLOWAY, NJ 08205-9438
(609) 748-9600
(609) 748-9611
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22DI02243200
NJ
Other
Enumeration date
08/05/2011
Last updated
10/18/2011
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