Provider Demographics
NPI:1013225176
Name:ALDAN FAMILY DENTAL PC
Entity Type:Organization
Organization Name:ALDAN FAMILY DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBATICCHIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:856-740-5009
Mailing Address - Street 1:1144 HOOPER AVE
Mailing Address - Street 2:SUITE 201 B
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-8361
Mailing Address - Country:US
Mailing Address - Phone:732-914-1039
Mailing Address - Fax:732-914-8472
Practice Address - Street 1:523 N OAK AVE
Practice Address - Street 2:
Practice Address - City:ALDAN
Practice Address - State:PA
Practice Address - Zip Code:19018-3032
Practice Address - Country:US
Practice Address - Phone:215-425-3101
Practice Address - Fax:215-425-3117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-22
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038225122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty