Provider Demographics
NPI:1174714786
Name:DOMINICK CRINGOLI
Entity type:Organization
Organization Name:DOMINICK CRINGOLI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINICK
Authorized Official - Middle Name:L
Authorized Official - Last Name:CRINGOLI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD PA
Authorized Official - Phone:609-597-4600
Mailing Address - Street 1:790 LYNWOOD ST
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-1318
Mailing Address - Country:US
Mailing Address - Phone:609-597-4600
Mailing Address - Fax:
Practice Address - Street 1:400 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3730
Practice Address - Country:US
Practice Address - Phone:609-597-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI008127001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty