Provider Demographics
NPI:1346953973
Name:JAFFERY ORAL SURGERY
Entity Type:Organization
Organization Name:JAFFERY ORAL SURGERY
Other - Org Name:UNION MILL ORAL SURGERY & DENTAL IMPLANT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FIZZA
Authorized Official - Middle Name:AFTAB
Authorized Official - Last Name:JAFFERY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MD
Authorized Official - Phone:248-568-6512
Mailing Address - Street 1:115 UNION MILL RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-6299
Mailing Address - Country:US
Mailing Address - Phone:856-437-5225
Mailing Address - Fax:
Practice Address - Street 1:115 UNION MILL RD
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-6299
Practice Address - Country:US
Practice Address - Phone:856-437-5225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-28
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty