| Old Bridge Family Orthodontics Llc | |
|
28 Throckmorton Ln Suite 104 Old Bridge NJ 08857-2558 | |
| (732) 727-6666 | |
| (732) 679-5522 |
| Full Name | Old Bridge Family Orthodontics Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 28 Throckmorton Ln, Old Bridge, New Jersey |
| Authorized Official Name and Position | Virgil Jason Vives (ORTHODONTIST) |
| Authorized Official Contact | 7327276666 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Old Bridge Family Orthodontics Llc 28 Throckmorton Ln Suite 104 Old Bridge NJ 08857-2558 Ph: (732) 727-6666 | Old Bridge Family Orthodontics Llc 28 Throckmorton Ln Suite 104 Old Bridge NJ 08857-2558 Ph: (732) 727-6666 |
| NPI Number | 1730406109 |
|---|---|
| Provider Enumeration Date | 04/26/2010 |
| Last Update Date | 04/26/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730406109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 22DIO46000 (New Jersey) | Primary |
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