Provider Demographics
NPI:1811038821
Name:WARREN M. MERGUERIAN, JR., DDS, PA
Entity Type:Organization
Organization Name:WARREN M. MERGUERIAN, JR., DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MERGUERIAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-270-6868
Mailing Address - Street 1:931 FISCHER BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3834
Mailing Address - Country:US
Mailing Address - Phone:732-270-6868
Mailing Address - Fax:
Practice Address - Street 1:931 FISCHER BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-3834
Practice Address - Country:US
Practice Address - Phone:732-270-6868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty