| Lanzi/burke Oral & Maxillofacial Surgeons | |
|
15 E Euclid Ave Haddonfield NJ 08033-2300 | |
| (856) 795-4600 | |
| (856) 795-4697 |
| Full Name | Lanzi/burke Oral & Maxillofacial Surgeons |
|---|---|
| Speciality | Dentist |
| Location | 15 E Euclid Ave, Haddonfield, New Jersey |
| Authorized Official Name and Position | Guy L Lanzi (PRESIDENT) |
| Authorized Official Contact | 8567954600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lanzi/burke Oral & Maxillofacial Surgeons 449 Hurffville Crosskeys Rd Unit Ii Sewell NJ 08080-9369 Ph: (856) 582-4222 | Lanzi/burke Oral & Maxillofacial Surgeons 15 E Euclid Ave Haddonfield NJ 08033-2300 Ph: (856) 795-4600 |
| NPI Number | 1053330217 |
|---|---|
| Provider Enumeration Date | 07/19/2006 |
| Last Update Date | 08/23/2019 |
| Medicare PECOS PAC ID | 7315900313 |
|---|---|
| Medicare Enrollment ID | O20041110000879 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053330217 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DI015089 (New Jersey) | Primary |
| Provider Name | Guy L Lanzi |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1134182678 PECOS PAC ID: 0941277529 Enrollment ID: I20040914000044 |
| Provider Name | Jonathan E Burke |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1275596082 PECOS PAC ID: 0840267423 Enrollment ID: I20040914000053 |
| Provider Name | Elizabeth A Wagner |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1659545184 PECOS PAC ID: 8729117346 Enrollment ID: I20100520000045 |
| Provider Name | Bryan M Nack |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1073966545 PECOS PAC ID: 7416377973 Enrollment ID: I20201022000029 |
| Provider Name | Yaniv David Harel |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1881009371 PECOS PAC ID: 8921225681 Enrollment ID: I20210701003280 |
| Provider Name | Diana Lin |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1457771545 PECOS PAC ID: 8426451543 Enrollment ID: I20210727004105 |
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