Provider Demographics
NPI:1184778763
Name:THE TMJ & SLEEP THERAPY CENTRE OF MONMOUTH, LLC
Entity type:Organization
Organization Name:THE TMJ & SLEEP THERAPY CENTRE OF MONMOUTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:S
Authorized Official - Last Name:KULAGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-449-3778
Mailing Address - Street 1:1010 STATE ROUTE 71
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762-2031
Mailing Address - Country:US
Mailing Address - Phone:732-449-3778
Mailing Address - Fax:732-449-3788
Practice Address - Street 1:1010 STATE ROUTE 71
Practice Address - Street 2:SUITE 4
Practice Address - City:SPRING LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07762-2031
Practice Address - Country:US
Practice Address - Phone:732-449-3778
Practice Address - Fax:732-449-3788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDIO14329122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty