Provider Demographics
NPI:1982852778
Name:NORTH JERSEY ORAL SURGEONS, P.A.
Entity Type:Organization
Organization Name:NORTH JERSEY ORAL SURGEONS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:KUCHLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-839-7201
Mailing Address - Street 1:2035 HAMBURG TPKE
Mailing Address - Street 2:SUITE J
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-6251
Mailing Address - Country:US
Mailing Address - Phone:973-839-7201
Mailing Address - Fax:973-839-5233
Practice Address - Street 1:2035 HAMBURG TPKE
Practice Address - Street 2:SUITE J
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-6251
Practice Address - Country:US
Practice Address - Phone:973-839-7201
Practice Address - Fax:973-839-5233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ117551223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ036330Medicare PIN