Provider Demographics
NPI:1750302220
Name:FAY, JAMES J (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:FAY
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 1:1431 LAKEWOOD RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1903
Mailing Address - Country:US
Mailing Address - Phone:732-223-8800
Mailing Address - Fax:732-223-8466
Practice Address - Street 1:1431 LAKEWOOD RD
Practice Address - Street 2:SUITE A
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1903
Practice Address - Country:US
Practice Address - Phone:732-223-8800
Practice Address - Fax:732-223-8466
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ163701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice