Provider Demographics
NPI:1346372000
Name:DR SANTO TRUFOLO & DR ALEX SHOR PA
Entity Type:Organization
Organization Name:DR SANTO TRUFOLO & DR ALEX SHOR PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR.
Authorized Official - Prefix:
Authorized Official - First Name:VIKI
Authorized Official - Middle Name:
Authorized Official - Last Name:VENABLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-531-8533
Mailing Address - Street 1:1907 HIGHWAY 35
Mailing Address - Street 2:SUITE #4
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-2765
Mailing Address - Country:US
Mailing Address - Phone:732-531-8533
Mailing Address - Fax:732-531-0584
Practice Address - Street 1:1907 HIGHWAY 35
Practice Address - Street 2:SUITE #4
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-2765
Practice Address - Country:US
Practice Address - Phone:732-531-8533
Practice Address - Fax:732-531-0584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22DI0137280OtherGENERAL DENTIST
NJ22DI0215140OtherGENERAL DENTIST