1659166775 NPI number — DOROBA ORAL SURGERY AND DENTAL IMPLANT CENTER,LLC

Table of content: (NPI 1659166775)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659166775 NPI number — DOROBA ORAL SURGERY AND DENTAL IMPLANT CENTER,LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DOROBA ORAL SURGERY AND DENTAL IMPLANT CENTER,LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
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NPI Number Information

NPI Number:
1659166775
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
344 CHEWS LANDING RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HADDONFIELD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08033-3840
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-847-7554
Provider Business Mailing Address Fax Number:
856-556-6647

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1808 SPRINGDALE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHERRY HILL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08003-2002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-847-7554
Provider Business Practice Location Address Fax Number:
856-556-6647
Provider Enumeration Date:
04/10/2025

Additional Information

Authorized Official

Authorized Official Last Name:
DOROBA
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
JOSEPH
Authorized Official Title or Position:
OWNER/SURGEON
Authorized Official Telephone Number:
609-847-7554

Provider Taxonomy Codes

  • Taxonomy code: 1223S0112X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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