Provider Demographics
NPI:1073523023
Name:PINO, JOSEPH B (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:B
Last Name:PINO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-2936
Mailing Address - Country:US
Mailing Address - Phone:856-234-9003
Mailing Address - Fax:856-234-8097
Practice Address - Street 1:1200 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-2936
Practice Address - Country:US
Practice Address - Phone:856-234-9003
Practice Address - Fax:856-234-8097
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ169961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice