Provider Demographics
NPI:1871516823
Name:HAMBERGER DENTAL ASSOCIATES, PA
Entity type:Organization
Organization Name:HAMBERGER DENTAL ASSOCIATES, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAMBERGER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-992-0075
Mailing Address - Street 1:155 S LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-3030
Mailing Address - Country:US
Mailing Address - Phone:973-992-0075
Mailing Address - Fax:973-992-4811
Practice Address - Street 1:155 S LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-3030
Practice Address - Country:US
Practice Address - Phone:973-992-0075
Practice Address - Fax:973-992-4811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ14043NJ1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty