Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 22DI00771000 | NJ |
NPI | 1578920260 |
---|---|
Provider Name | Dr. Edward A Tanski JR. |
First Address | Ocean City, NJ 08226 |
Second Address | West Berlin, NJ 08091 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2016 |
Last Update Date | 26/01/2016 |