Provider Demographics
NPI:1770617797
Name:JOSEPH M MICALE DMD PA
Entity type:Organization
Organization Name:JOSEPH M MICALE DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:MICALE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-766-1515
Mailing Address - Street 1:12 RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-1760
Mailing Address - Country:US
Mailing Address - Phone:908-766-1515
Mailing Address - Fax:908-766-6710
Practice Address - Street 1:12 RIDGE ST
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-1760
Practice Address - Country:US
Practice Address - Phone:908-766-1515
Practice Address - Fax:908-766-6710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI016657001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty