Provider Demographics
NPI:1407068216
Name:MICHAEL MASER, AGNIESZKA BARA, D.M.D., LLC
Entity Type:Organization
Organization Name:MICHAEL MASER, AGNIESZKA BARA, D.M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MASER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-537-9922
Mailing Address - Street 1:476 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLESEX
Mailing Address - State:NJ
Mailing Address - Zip Code:08846-1930
Mailing Address - Country:US
Mailing Address - Phone:732-537-9922
Mailing Address - Fax:732-537-9920
Practice Address - Street 1:476 UNION AVE
Practice Address - Street 2:
Practice Address - City:MIDDLESEX
Practice Address - State:NJ
Practice Address - Zip Code:08846
Practice Address - Country:US
Practice Address - Phone:732-537-9922
Practice Address - Fax:732-537-9920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ149651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty