Provider Demographics
NPI:1568478089
Name:MOSKOWITZ, JOEL M (DMD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:M
Last Name:MOSKOWITZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 BOWLING GREEN PKWY
Mailing Address - Street 2:
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07849-2445
Mailing Address - Country:US
Mailing Address - Phone:973-663-4220
Mailing Address - Fax:973-663-6136
Practice Address - Street 1:28 BOWLING GREEN PKWY
Practice Address - Street 2:
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07849-2445
Practice Address - Country:US
Practice Address - Phone:973-663-4220
Practice Address - Fax:973-663-6136
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI009778001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22DI00977800OtherDENTAL LICENSE