| Valley Oral Surgery | |
|
370 Union Blvd Totowa NJ 07512-2561 | |
| (973) 389-1110 | |
| Not Available |
| Full Name | Valley Oral Surgery |
|---|---|
| Speciality | Dentist |
| Location | 370 Union Blvd, Totowa, New Jersey |
| Authorized Official Name and Position | Vito Modugno (OWNER PRESIDENT) |
| Authorized Official Contact | 2016810440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Oral Surgery 370 Union Blvd Totowa NJ 07512-2561 Ph: () - | Valley Oral Surgery 370 Union Blvd Totowa NJ 07512-2561 Ph: (973) 389-1110 |
| NPI Number | 1700923216 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 08/26/2007 |
| Medicare PECOS PAC ID | 9537356092 |
|---|---|
| Medicare Enrollment ID | O20101209000383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700923216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | DI 18054 (New Jersey) | Primary |
| Provider Name | Vito L Modugno |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1992842496 PECOS PAC ID: 4880685239 Enrollment ID: I20040524000436 |
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