Provider Demographics
NPI:1841404498
Name:BERRETONE, JOSEPH A JR (DMD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:BERRETONE
Suffix:JR
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 1:4503 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-5733
Mailing Address - Country:US
Mailing Address - Phone:609-345-3377
Mailing Address - Fax:
Practice Address - Street 1:4503 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-5733
Practice Address - Country:US
Practice Address - Phone:609-345-3377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D101801900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist