Provider Demographics
NPI:1578220588
Name:SZPERNOGA, ANETA MARIA (DMD)
Entity Type:Individual
Prefix:
First Name:ANETA
Middle Name:MARIA
Last Name:SZPERNOGA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PECAN LN
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07438-9134
Mailing Address - Country:US
Mailing Address - Phone:908-938-8274
Mailing Address - Fax:
Practice Address - Street 1:10 PECAN LN
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07438-9134
Practice Address - Country:US
Practice Address - Phone:908-938-8274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI028713001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice