Provider Demographics
NPI:1851436919
Name:WHILDEN, DALE C (DMD)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:C
Last Name:WHILDEN
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 1:7 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:OCEAN GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07756-1303
Mailing Address - Country:US
Mailing Address - Phone:732-774-4321
Mailing Address - Fax:
Practice Address - Street 1:64 MAIN AVE
Practice Address - Street 2:
Practice Address - City:OCEAN GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07756-1319
Practice Address - Country:US
Practice Address - Phone:732-774-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ122951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223825713OtherTAX ID