Provider Demographics
NPI:1598745531
Name:FLUGRAD, GEORGE (DMD, MS)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:FLUGRAD
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:453 AMBOY AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-2960
Mailing Address - Country:US
Mailing Address - Phone:732-442-1860
Mailing Address - Fax:732-874-5198
Practice Address - Street 1:453 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-2960
Practice Address - Country:US
Practice Address - Phone:732-442-1860
Practice Address - Fax:732-874-5198
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ127951223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJFL16093Medicare ID - Type Unspecified
NJ1873407Medicaid