Provider Demographics
NPI:1801870134
Name:DPB DMD DENTAL ASSOCIATES P.A.
Entity type:Organization
Organization Name:DPB DMD DENTAL ASSOCIATES P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:PARKER
Authorized Official - Last Name:BODE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-458-2288
Mailing Address - Street 1:56 RAMTOWN GREENVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3830
Mailing Address - Country:US
Mailing Address - Phone:732-458-2288
Mailing Address - Fax:732-458-7073
Practice Address - Street 1:56 RAMTOWN GREENVILLE RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3830
Practice Address - Country:US
Practice Address - Phone:732-458-2288
Practice Address - Fax:732-458-7073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ130631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty