Provider Demographics
NPI:1194846014
Name:ASSOCIATES IN ORAL & MAXILLOFACIAL SURGERY, PA
Entity Type:Organization
Organization Name:ASSOCIATES IN ORAL & MAXILLOFACIAL SURGERY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:EIDELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-376-1144
Mailing Address - Street 1:475 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1005
Mailing Address - Country:US
Mailing Address - Phone:973-376-1144
Mailing Address - Fax:
Practice Address - Street 1:475 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1005
Practice Address - Country:US
Practice Address - Phone:973-376-1144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty