| Organization Name: | JAMES J SUSACK DMD PC |
| NPI Number: | 1457590325 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES J SUSACK (PRESIDENT) |
| Mailing Address: | 151 N Broadway Pennsville |
| State: | NJ US |
| Postal Code: | 080701648 |
| Phone Number: | 8566782033 |
| Fax Number: | 8566782845 |
| NPI Enumeration Date: | 02/16/2009 |
| NPI Last Update Date: | 02/16/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DI018099 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |