Provider Demographics
NPI:1386847788
Name:G.M. DENTAL CENTER INC.
Entity Type:Organization
Organization Name:G.M. DENTAL CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MCNAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-775-1510
Mailing Address - Street 1:2116 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4672
Mailing Address - Country:US
Mailing Address - Phone:732-775-1510
Mailing Address - Fax:732-531-5332
Practice Address - Street 1:2116 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4672
Practice Address - Country:US
Practice Address - Phone:732-775-1510
Practice Address - Fax:732-531-5332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1007747001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty