Provider Demographics
NPI:1982003893
Name:A-ONE DENTAL OF BAYVILLE LLC
Entity Type:Organization
Organization Name:A-ONE DENTAL OF BAYVILLE LLC
Other - Org Name:BAYVILLE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PANTALEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-269-3200
Mailing Address - Street 1:800 ATLANTIC CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721
Mailing Address - Country:US
Mailing Address - Phone:732-269-3200
Mailing Address - Fax:732-269-2211
Practice Address - Street 1:800 ATLANTIC CITY BLVD
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721
Practice Address - Country:US
Practice Address - Phone:732-269-3200
Practice Address - Fax:732-269-2211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty