Dr Theodore A Niebloom, DMD | |
101 Old Short Hills Road, West Orange, NJ 07052 | |
(973) 736-7616 | |
(973) 325-3487 |
Full Name | Dr Theodore A Niebloom |
---|---|
Gender | Male |
Speciality | Dentist - Oral And Maxillofacial Surgery |
Location | 101 Old Short Hills Road, West Orange, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689750705 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223S0112X | Dentist - Oral And Maxillofacial Surgery | 22DI01604200 (New Jersey) | Primary |
Entity Name | Metropolitan Craniofacial Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306922422 PECOS PAC ID: 3577698224 Enrollment ID: O20100319000175 |
Mailing Address | Practice Location Address |
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Dr Theodore A Niebloom, DMD 101 Old Short Hills Road, West Orange, NJ 07052 Ph: (973) 736-7616 | Dr Theodore A Niebloom, DMD 101 Old Short Hills Road, West Orange, NJ 07052 Ph: (973) 736-7616 |
Dr. Allan Jeremy Stein, DMD Dentist Medicare: Medicare Enrolled Practice Location: 769 Northfield Ave Ste 154, West Orange, NJ 07052 Phone: 973-736-0111 Fax: 973-325-6442 | |
Dr. Seungwon Yoon, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 412 Pleasant Valley Way Ste 2, West Orange, NJ 07052 Phone: 973-731-2468 | |
Dr. Noureldein K Elshamma, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 77 Oak Ave, West Orange, NJ 07052 Phone: 973-901-3031 | |
Eden Baluyote Vincent, DMD LLC Dentist Medicare: Medicare Enrolled Practice Location: 508 Pleasant Valley Way, West Orange, NJ 07052 Phone: 973-731-0087 Fax: 973-731-0024 | |
Brian Calvin Martin, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 622 Eagle Rock Ave, Suite 105, West Orange, NJ 07052 Phone: 973-325-1011 Fax: 973-325-1183 | |
Dr. Ivan Fredric Stein, DDS Dentist Medicare: May Accept Medicare Assignments Practice Location: 769 Northfield Ave, Suite 154, West Orange, NJ 07052 Phone: 973-736-0111 Fax: 973-325-6442 | |
Dr. Renee M. Arace, D.M.D. Dentist Medicare: Medicare Enrolled Practice Location: 51 Pleasant Valley Way, West Orange, NJ 07052 Phone: 973-325-9933 Fax: 973-325-9210 |