Provider Demographics
NPI:1467160945
Name:ATLAS DENTAL GROUP
Entity Type:Organization
Organization Name:ATLAS DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:AHLO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-905-2856
Mailing Address - Street 1:2279 ROUTE 33 STE 504
Mailing Address - Street 2:
Mailing Address - City:HAMILTON SQUARE
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-1750
Mailing Address - Country:US
Mailing Address - Phone:609-584-7200
Mailing Address - Fax:
Practice Address - Street 1:2279 ROUTE 33 STE 504
Practice Address - Street 2:
Practice Address - City:HAMILTON SQUARE
Practice Address - State:NJ
Practice Address - Zip Code:08690-1750
Practice Address - Country:US
Practice Address - Phone:609-584-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental