Provider Demographics
NPI:1447857685
Name:DENTAL HEALTH CENTER OF MONMOUTH BEACH
Entity type:Organization
Organization Name:DENTAL HEALTH CENTER OF MONMOUTH BEACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:DICARLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-870-9658
Mailing Address - Street 1:27 BEACH RD STE 1
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:07750-1387
Mailing Address - Country:US
Mailing Address - Phone:732-870-9658
Mailing Address - Fax:732-870-1952
Practice Address - Street 1:27 BEACH RD STE 1
Practice Address - Street 2:
Practice Address - City:MONMOUTH BEACH
Practice Address - State:NJ
Practice Address - Zip Code:07750-1387
Practice Address - Country:US
Practice Address - Phone:732-870-9658
Practice Address - Fax:732-870-1952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-01
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental