Provider Demographics
NPI:1730156126
Name:PIOTROWSKI, JOSEPH C (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:PIOTROWSKI
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 1:1039 SHEILA DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3535
Mailing Address - Country:US
Mailing Address - Phone:732-363-0800
Mailing Address - Fax:732-367-5206
Practice Address - Street 1:400 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-3214
Practice Address - Country:US
Practice Address - Phone:732-363-0800
Practice Address - Fax:732-367-5206
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ164371223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ16437OtherSTATE LICENSE
NJU02553Medicare UPIN