Male or Other

Dr. Peter A. Defazio DMD

General Practice Dentistry in Long Branch, NJ(View on Map)

Full Name

Dr. Peter A Defazio DMD

NPI Number

1770614331

NPI Type

Individual Provider

Gender

Male

Enumeration Date

03/07/2007

Specialties

(Taxonomies)

Code

1223G0001X

Primary Taxonomy

Yes

Licenses

State

New Jersey

License Number

17239

Contact
Information

Purpose

Mailing
Location

Address

279 3RD AVE
279 3RD AVE

City

Long Branch
Long Branch

State

NJ
NJ

Postal Code

07740-6205
07740-6205

Country

US
US

Telephone Number

(732) 222-1533
(732) 222-1533

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/08/2007

Provider Address

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