Provider Demographics
NPI:1972652394
Name:CARCARA, SALVATORE JOSEPH (DMD MS)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:JOSEPH
Last Name:CARCARA
Suffix:
Gender:M
Credentials:DMD MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 BROADWAY
Mailing Address - Street 2:SUITE 41
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675
Mailing Address - Country:US
Mailing Address - Phone:201-664-4443
Mailing Address - Fax:201-664-9101
Practice Address - Street 1:381 BROADWAY
Practice Address - Street 2:SUITE 41
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675
Practice Address - Country:US
Practice Address - Phone:201-664-4443
Practice Address - Fax:201-664-9101
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0196011223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01527893OtherUNITED CONCORDIA PROVIDER
NJ1010OtherDELTA DENTAL PIN
NJ19601OtherDELTA DENTAL PROVIDER