| Metropolitan Craniofacial Center | |
|
101 Old Short Hills Road Penthouse Ii West Orange NJ 07052 | |
| (973) 736-7616 | |
| (973) 325-3487 |
| Full Name | Metropolitan Craniofacial Center |
|---|---|
| Speciality | Dentist |
| Location | 101 Old Short Hills Road, West Orange, New Jersey |
| Authorized Official Name and Position | Theodore A Niebloom (DOCTOR VP) |
| Authorized Official Contact | 9737367616 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Metropolitan Craniofacial Center 101 Old Short Hills Road Penthouse Ii West Orange NJ 07052 Ph: (973) 736-7616 | Metropolitan Craniofacial Center 101 Old Short Hills Road Penthouse Ii West Orange NJ 07052 Ph: (973) 736-7616 |
| NPI Number | 1306922422 |
|---|---|
| Provider Enumeration Date | 10/31/2006 |
| Last Update Date | 10/05/2016 |
| Medicare PECOS PAC ID | 3577698224 |
|---|---|
| Medicare Enrollment ID | O20100319000175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306922422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | John P Amato |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1457487407 PECOS PAC ID: 1759416423 Enrollment ID: I20100319000331 |
| Provider Name | Gary J Vitale |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1861578981 PECOS PAC ID: 3779618434 Enrollment ID: I20100319000380 |
| Provider Name | Theodore A Niebloom |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1689750705 PECOS PAC ID: 4789719444 Enrollment ID: I20100320000003 |
| Provider Name | Henry J Falk |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1497831515 PECOS PAC ID: 9234264995 Enrollment ID: I20100320000007 |
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Northfield Dental Group Dental Clinic Medicare: Medicare Enrolled Practice Location: 769 Northfield Ave, Suite 154, West Orange, NJ 07052 Phone: 973-736-0111 Fax: 973-325-6442 | |
Riverside Oral Surgery - West Orange Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 Old Short Hills Rd Ph 2, West Orange, NJ 07052 Phone: 201-487-6565 | |
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