Provider Demographics
NPI:1568599264
Name:TOWNE CENTRE FAMILY DENTAL
Entity Type:Organization
Organization Name:TOWNE CENTRE FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:INTERNOSCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-874-4555
Mailing Address - Street 1:419 US HIGHWAY 206
Mailing Address - Street 2:TOWNE CENTRE
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5094
Mailing Address - Country:US
Mailing Address - Phone:908-874-4455
Mailing Address - Fax:908-281-9560
Practice Address - Street 1:419 US HIGHWAY 206
Practice Address - Street 2:TOWNE CENTRE
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-5094
Practice Address - Country:US
Practice Address - Phone:908-874-4455
Practice Address - Fax:908-281-9560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ153051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty