| Riverside Oral Surgery | |
|
340 E Northfield Rd Ste 1c Livingston NJ 07039-4892 | |
| (973) 992-4750 | |
| Not Available |
| Full Name | Riverside Oral Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 340 E Northfield Rd Ste 1c, Livingston, New Jersey |
| Authorized Official Name and Position | Lisa D Brown (OFFICE MANAGER) |
| Authorized Official Contact | 2014876565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Oral Surgery 130 Kinderkamack Rd Ste 204 River Edge NJ 07661-1931 Ph: (201) 487-6565 | Riverside Oral Surgery 340 E Northfield Rd Ste 1c Livingston NJ 07039-4892 Ph: (973) 992-4750 |
| NPI Number | 1255826939 |
|---|---|
| Provider Enumeration Date | 06/26/2018 |
| Last Update Date | 09/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255826939 | NPI | - | NPPES |
| 22DI02584805 | Other | NJ | STATE DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 22DI02584805 (New Jersey) | Primary |
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