Provider Demographics
NPI:1043212806
Name:CENTRAL JERSEY DENTAL
Entity Type:Organization
Organization Name:CENTRAL JERSEY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:BLUMENSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-251-7766
Mailing Address - Street 1:410 SPOTSWOOD ENGLISHTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-8615
Mailing Address - Country:US
Mailing Address - Phone:732-251-7766
Mailing Address - Fax:732-251-7676
Practice Address - Street 1:410 SPOTSWOOD ENGLISHTOWN RD
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-8615
Practice Address - Country:US
Practice Address - Phone:732-251-7766
Practice Address - Fax:732-251-7676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6398790001Medicare NSC