David J Garbolino, DMD

Individual provider Active NPI General Practice Dentistry · Wall, NJ

NPI 1750546263 · NPPES record last updated Jul 23, 2008

Key facts

NPI
1750546263
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
22DI01405300 (NJ)
Practice address
1560 Highway 138
Wall, NJ 07719-3743
Phone
(732) 681-4313
Fax
(732) 681-3311
NPI assigned
Jul 23, 2008
Sex
Male
Sole proprietor
Yes

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
22DI01405300NJMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI01405300 NJ Yes

Addresses

Primary practice location

1560 Highway 138
Wall, NJ 07719-3743

Mailing address

1560 Highway 138
Wall, NJ 07719-3743
Phone (732) 681-4313

Other providers in Wall, NJ

All providers in Wall, NJ · General Practice Dentistry in New Jersey

Sources for this page

Verify at the official NPI Registry.