Provider Demographics
NPI:1679799688
Name:OKESON FAMILY DENTAL, PC
Entity Type:Organization
Organization Name:OKESON FAMILY DENTAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:THOGODE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-948-5000
Mailing Address - Street 1:PO BOX 810
Mailing Address - Street 2:
Mailing Address - City:BRANCHVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07826-0810
Mailing Address - Country:US
Mailing Address - Phone:973-948-5000
Mailing Address - Fax:973-948-2280
Practice Address - Street 1:ONE COUNTRY LANE
Practice Address - Street 2:
Practice Address - City:BRANCHVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07826
Practice Address - Country:US
Practice Address - Phone:973-948-5000
Practice Address - Fax:973-948-2280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty