| Shore Oral And Maxillofacial Surgery, Llc | |
|
54 W Jimmie Leeds Rd Suite 6 Galloway NJ 08205-9438 | |
| (609) 748-9600 | |
| (609) 748-9611 |
| Full Name | Shore Oral And Maxillofacial Surgery, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 54 W Jimmie Leeds Rd, Galloway, New Jersey |
| Authorized Official Name and Position | Boris Kalika (OWNER) |
| Authorized Official Contact | 6097489600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shore Oral And Maxillofacial Surgery, Llc 54 W Jimmie Leeds Rd Suite 6 Galloway NJ 08205-9438 Ph: (609) 748-9600 | Shore Oral And Maxillofacial Surgery, Llc 54 W Jimmie Leeds Rd Suite 6 Galloway NJ 08205-9438 Ph: (609) 748-9600 |
| NPI Number | 1952680100 |
|---|---|
| Provider Enumeration Date | 08/05/2011 |
| Last Update Date | 10/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952680100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 22DI02243200 (New Jersey) | Primary |
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