| NPI | 1790800423 |
|---|---|
| Former Legal Business Name | COASTAL ORAL SURGERY, PA |
| Entity Type | Organization |
| Authorized Contact | SHARLENE MARPLE Administrator 732-286-1199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2024-03-06 |