Provider Demographics
NPI:1346675022
Name:ALL DENTAL SPECIALTIES OF MATAWAN, PA
Entity Type:Organization
Organization Name:ALL DENTAL SPECIALTIES OF MATAWAN, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIRANJAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SAVANI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-464-4254
Mailing Address - Street 1:401 COMMERCE DR
Mailing Address - Street 2:SUITE108
Mailing Address - City:FT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2714
Mailing Address - Country:US
Mailing Address - Phone:215-460-4254
Mailing Address - Fax:215-646-6166
Practice Address - Street 1:125 MAIN ST
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-2654
Practice Address - Country:US
Practice Address - Phone:732-583-1144
Practice Address - Fax:732-583-0114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D102312900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty