Vincent C Noonan

Individual provider Active NPI General Practice Dentistry · North Brunswick, NJ

NPI 1013083633 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1013083633
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DIO08342 (NJ)
Practice address
2003 US Highway 130 Ste C
North Brunswick, NJ 08902-4810
Phone
(732) 297-0549
NPI assigned
Nov 27, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DIO08342NJMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DIO08342 NJ Yes

Addresses

Primary practice location

2003 US Highway 130 Ste C
North Brunswick, NJ 08902-4810

Mailing address

2003 US Highway 130 Ste C
North Brunswick, NJ 08902-4810
Phone (732) 297-0549

Other identifiers

IdentifierTypeStateIssuer
DIO08342OtherNJDENTAL LICENSE NUMBER

Other providers in North Brunswick, NJ

All providers in North Brunswick, NJ · General Practice Dentistry in New Jersey

Sources for this page

Verify at the official NPI Registry.