Provider Demographics
NPI:1083718282
Name:DOOLEY, EDWARD J (DMD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:J
Last Name:DOOLEY
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 1:1109 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762-1328
Mailing Address - Country:US
Mailing Address - Phone:732-974-2288
Mailing Address - Fax:732-974-8070
Practice Address - Street 1:1109 3RD AVE
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07762-1328
Practice Address - Country:US
Practice Address - Phone:732-974-2288
Practice Address - Fax:732-974-8070
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice