Provider Demographics
NPI:1912067158
Name:HOWARD R SIEGLER DDS PA
Entity Type:Organization
Organization Name:HOWARD R SIEGLER DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:SIEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-791-7822
Mailing Address - Street 1:15 22 FAIR LAWN AVE
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410
Mailing Address - Country:US
Mailing Address - Phone:201-791-7822
Mailing Address - Fax:201-791-5877
Practice Address - Street 1:15 22 FAIR LAWN AVE
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410
Practice Address - Country:US
Practice Address - Phone:201-791-7822
Practice Address - Fax:201-791-5877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86011223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
136249Medicare ID - Type Unspecified
136249Medicare UPIN