Provider Demographics
NPI:1578037156
Name:MONTALBANO, JOSEPH SALVATORE (DMD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:SALVATORE
Last Name:MONTALBANO
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 1:5 WEYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1009
Mailing Address - Country:US
Mailing Address - Phone:609-561-0058
Mailing Address - Fax:609-561-7586
Practice Address - Street 1:5 WEYMOUTH RD
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1009
Practice Address - Country:US
Practice Address - Phone:609-561-0058
Practice Address - Fax:609-561-7586
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02724400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist