Provider Demographics
NPI:1962757732
Name:SHORE POINTS ORAL SURGERY & IMPLANT CENTER LLC
Entity type:Organization
Organization Name:SHORE POINTS ORAL SURGERY & IMPLANT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:A
Authorized Official - Last Name:GALANTE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-582-8131
Mailing Address - Street 1:1631 ROUTE 88 W
Mailing Address - Street 2:SUITE B
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3048
Mailing Address - Country:US
Mailing Address - Phone:732-528-8131
Mailing Address - Fax:732-582-2224
Practice Address - Street 1:1631 ROUTE 88 W
Practice Address - Street 2:SUITE B
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3048
Practice Address - Country:US
Practice Address - Phone:732-528-8131
Practice Address - Fax:732-582-2224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty