Provider Demographics
NPI:1295073633
Name:THE DENTIST'S OFFICE, LLC
Entity type:Organization
Organization Name:THE DENTIST'S OFFICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-566-6060
Mailing Address - Street 1:1070 ROUTE 34
Mailing Address - Street 2:SUITE B
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-3469
Mailing Address - Country:US
Mailing Address - Phone:732-566-6060
Mailing Address - Fax:
Practice Address - Street 1:1070 ROUTE 34
Practice Address - Street 2:SUITE B
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-3469
Practice Address - Country:US
Practice Address - Phone:732-566-6060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty