| Keyport Dental Group | |
|
2407 Bridge Ave Point Pleasant Boro NJ 08742-4334 | |
| (732) 714-1030 | |
| (732) 714-1142 |
| Full Name | Keyport Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 2407 Bridge Ave, Point Pleasant Boro, New Jersey |
| Authorized Official Name and Position | Joseph Richard Zicchino (OWNER) |
| Authorized Official Contact | 7327141030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keyport Dental Group 2407 Bridge Ave Point Pleasant Boro NJ 08742-4334 Ph: (732) 714-1030 | Keyport Dental Group 2407 Bridge Ave Point Pleasant Boro NJ 08742-4334 Ph: (732) 714-1030 |
| NPI Number | 1346515384 |
|---|---|
| Provider Enumeration Date | 03/08/2012 |
| Last Update Date | 03/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346515384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DI20087 (New Jersey) | Primary |
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