Provider Demographics
NPI:1710020078
Name:MAGALIO, ALBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:
Last Name:MAGALIO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX U
Mailing Address - Street 2:
Mailing Address - City:BLAIRSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07825-0980
Mailing Address - Country:US
Mailing Address - Phone:908-362-5090
Mailing Address - Fax:908-362-5780
Practice Address - Street 1:1 FOOTBRIDGE LN
Practice Address - Street 2:
Practice Address - City:BLAIRSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07825-2512
Practice Address - Country:US
Practice Address - Phone:908-362-5090
Practice Address - Fax:908-362-5780
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 17822122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist