Provider Demographics
NPI:1407988280
Name:SANTO O. TRUFOLO, DMD, LLC & ALEKSANDR I. SHOR DMD
Entity Type:Organization
Organization Name:SANTO O. TRUFOLO, DMD, LLC & ALEKSANDR I. SHOR DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR.
Authorized Official - Prefix:
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-477-1335
Mailing Address - Street 1:445 BRICK BLVD
Mailing Address - Street 2:SUITE #307
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6048
Mailing Address - Country:US
Mailing Address - Phone:732-477-1335
Mailing Address - Fax:732-920-5758
Practice Address - Street 1:445 BRICK BLVD
Practice Address - Street 2:SUITE #307
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6048
Practice Address - Country:US
Practice Address - Phone:732-477-1335
Practice Address - Fax:732-920-5758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22DI0137280OtherGENERAL DENTIST
NJ22DI0215140OtherGENERAL DENTIST