Provider Demographics
NPI:1356490189
Name:DAFONTE, DENNIS J (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:J
Last Name:DAFONTE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 FRIES MILL RD
Mailing Address - Street 2:SUITE G3
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012
Mailing Address - Country:US
Mailing Address - Phone:856-728-0707
Mailing Address - Fax:856-728-0154
Practice Address - Street 1:188 FRIES MILL RD
Practice Address - Street 2:SUITE G3
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012
Practice Address - Country:US
Practice Address - Phone:856-728-0707
Practice Address - Fax:856-728-0154
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D101632400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist