Chantilly Dental Group LLC

NPI #1629287412 in Keyport, New Jersey

Provider Information

NPI Number: 1629287412
Entity Type: Organization
Organization Name: Chantilly Dental Group LLC
Primary Specialty: Dentist
Enumeration Date: May 21, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1 STATE ROUTE 35
City: Keyport
State: New Jersey
ZIP Code: 07735-1128
Phone: (732) 888-7770

Authorized Official

Name: DR. DAVID E. TARRAB, DDS
Title: MANAGING MEMBER
Phone: (732) 888-7770

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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