| Alliance Oral Surgery | |
|
1301 Route 72 W Suite 220 Manahawkin NJ 08050-2483 | |
| (609) 597-9600 | |
| (732) 842-5910 |
| Full Name | Alliance Oral Surgery |
|---|---|
| Speciality | Dentist |
| Location | 1301 Route 72 W, Manahawkin, New Jersey |
| Authorized Official Name and Position | John Frattellone (OWNER) |
| Authorized Official Contact | 7328425915 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Oral Surgery 515 Newman Springs Rd Lincroft NJ 07738-1426 Ph: (732) 842-5915 | Alliance Oral Surgery 1301 Route 72 W Suite 220 Manahawkin NJ 08050-2483 Ph: (609) 597-9600 |
| NPI Number | 1720212590 |
|---|---|
| Provider Enumeration Date | 05/08/2009 |
| Last Update Date | 12/31/2013 |
| Medicare PECOS PAC ID | 7810035847 |
|---|---|
| Medicare Enrollment ID | O20091112000367 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720212590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (New Jersey) | Primary |
| Provider Name | John P Frattellone |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1578535670 PECOS PAC ID: 4082664453 Enrollment ID: I20050125000279 |
| Provider Name | Khanh Q Nguyen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1235143892 PECOS PAC ID: 7315997681 Enrollment ID: I20050125000291 |
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