Provider Demographics
NPI:1588665483
Name:BOCIAN, JOSEPH ALLEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALLEN
Last Name:BOCIAN
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 1:6 AUER CT
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5828
Mailing Address - Country:US
Mailing Address - Phone:732-257-4062
Mailing Address - Fax:732-257-1621
Practice Address - Street 1:6 AUER CT
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5828
Practice Address - Country:US
Practice Address - Phone:732-257-4062
Practice Address - Fax:732-257-1621
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI011741001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice