Provider Demographics
NPI:1639913742
Name:ADVANCED DENTAL SLEEP MEDICINE AND TMJ OF SOUTH JERSEY LLC
Entity type:Organization
Organization Name:ADVANCED DENTAL SLEEP MEDICINE AND TMJ OF SOUTH JERSEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-890-1144
Mailing Address - Street 1:800 OCEAN RD
Mailing Address - Street 2:
Mailing Address - City:PT PLEASANT
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-4085
Mailing Address - Country:US
Mailing Address - Phone:732-890-1144
Mailing Address - Fax:
Practice Address - Street 1:800 OCEAN RD
Practice Address - Street 2:
Practice Address - City:PT PLEASANT
Practice Address - State:NJ
Practice Address - Zip Code:08742-4085
Practice Address - Country:US
Practice Address - Phone:732-890-1144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty