Albert Atalla Khalil, D.D.S.

Individual provider Active NPI General Practice Dentistry · South River, NJ

NPI 1861521221 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1861521221
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
22DI01943000 (NJ)
Practice address
29 Kamm Ave
South River, NJ 08882-2126
Phone
(732) 257-4749
Fax
(732) 257-6245
NPI assigned
Mar 3, 2007
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
22DI01943000NJMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI01943000 NJ Yes

Addresses

Primary practice location

29 Kamm Ave
South River, NJ 08882-2126

Mailing address

29 Kamm Ave
South River, NJ 08882-2126
Phone (732) 257-4749

Other providers in South River, NJ

All providers in South River, NJ · General Practice Dentistry in New Jersey

Sources for this page

Verify at the official NPI Registry.