Provider Demographics
NPI:1093173569
Name:DR. BENAIFER D. PREZIOSI, LLC
Entity Type:Organization
Organization Name:DR. BENAIFER D. PREZIOSI, LLC
Other - Org Name:COASTAL ORAL AND MAXILLOFACIAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENAIFER
Authorized Official - Middle Name:DON
Authorized Official - Last Name:PREZIOSI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:609-927-9090
Mailing Address - Street 1:199 NEW RD
Mailing Address - Street 2:SUITE 32
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-2025
Mailing Address - Country:US
Mailing Address - Phone:609-927-9090
Mailing Address - Fax:609-927-9091
Practice Address - Street 1:199 NEW RD
Practice Address - Street 2:SUITE 32
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-2025
Practice Address - Country:US
Practice Address - Phone:609-927-9090
Practice Address - Fax:609-927-9091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02353700261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental