Provider Demographics
NPI:1447086608
Name:APEX ORAL SURGERY, LLC
Entity type:Organization
Organization Name:APEX ORAL SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:JOHN ARMAND
Authorized Official - Last Name:CAPPETTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:908-514-5126
Mailing Address - Street 1:600 HUDSON ST APT 6E
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5925
Mailing Address - Country:US
Mailing Address - Phone:908-514-5126
Mailing Address - Fax:
Practice Address - Street 1:210 MAIN ST STE 2A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-2285
Practice Address - Country:US
Practice Address - Phone:973-210-7076
Practice Address - Fax:973-210-7071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0451099714OtherTAX ID NUMBER