NPI 1164618435

De Omilia Plastic Surgery PC

Organisation Oral & Maxillofacial Surgery (D.M.D.) Basking Ridge, NJ

Practice location

Address: 96 South Finley Ave, Basking Ridge, NJ 07920
Phone: (908) 221-1136
Fax: (908) 221-0482

Authorised official

Name: David Z Evdokimow
Title: Owner
Phone: (908) 221-1136

Registered specialties (3)

Oral & Maxillofacial Surgery (D.M.D.) Primary

Allopathic & Osteopathic Physicians Taxonomy 204E00000X Licence 25MA07315300 (NJ)

Other Oral & Maxillofacial Surgery providers in New Jersey →

Plastic Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 208200000X Licence 25MA07315300 (NJ)

Other Plastic Surgery providers in New Jersey →

Surgery of the Hand (Plastic Surgery) Physician

Allopathic & Osteopathic Physicians Taxonomy 2082S0105X Licence 25MA07315300 (NJ)

Registry record

NPI: 1164618435
Entity type: Organization
NPI issued: 20 Sep 2007
Record last updated: 3 Apr 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.