Provider Demographics
NPI:1548517295
Name:HUNTERDON FAMILY DENTAL PA
Entity type:Organization
Organization Name:HUNTERDON FAMILY DENTAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBATICCHIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-473-1444
Mailing Address - Street 1:276 US HIGHWAY 202/31
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1759
Mailing Address - Country:US
Mailing Address - Phone:732-914-1039
Mailing Address - Fax:732-914-8472
Practice Address - Street 1:276 US HIGHWAY 202/31
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1759
Practice Address - Country:US
Practice Address - Phone:732-914-1039
Practice Address - Fax:732-914-8472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-13
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI0174321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty