Provider Demographics
NPI:1629196134
Name:CARLOS MOGLIANESI, D.M.D. PC
Entity Type:Organization
Organization Name:CARLOS MOGLIANESI, D.M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:MOGLIANESI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-665-2300
Mailing Address - Street 1:8 PARTRIDGE RUN
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059
Mailing Address - Country:US
Mailing Address - Phone:732-356-6905
Mailing Address - Fax:
Practice Address - Street 1:1806 SPRINGFIELD AVE.
Practice Address - Street 2:
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974
Practice Address - Country:US
Practice Address - Phone:908-665-2300
Practice Address - Fax:908-665-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI151751223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty