| Organization Name: | RANDOLPH ORAL PATHOLOGY ASSOCIATES, LLC |
| NPI Number: | 1053745117 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JESSICA L WOLLENBERG (SOLE MBR) |
| Mailing Address: | 447 Route 10 Suite 5 Randolph |
| State: | NJ US |
| Postal Code: | 078692132 |
| Phone Number: | 9733280464 |
| Fax Number: | |
| NPI Enumeration Date: | 08/26/2013 |
| NPI Last Update Date: | 01/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0106X |
| License Number: | 22DI02546000 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Oral and Maxillofacial Pathology |
| Taxonomy Definition: | The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |