Provider Demographics
NPI:1477767788
Name:MICHAEL T. WARD DMD, PA
Entity Type:Organization
Organization Name:MICHAEL T. WARD DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-729-2181
Mailing Address - Street 1:27 W SHORE TRL
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1827
Mailing Address - Country:US
Mailing Address - Phone:973-729-2181
Mailing Address - Fax:973-729-1246
Practice Address - Street 1:27 W SHORE TRL
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1827
Practice Address - Country:US
Practice Address - Phone:973-729-2181
Practice Address - Fax:973-729-1246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18345122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty