| Bradley J Convissar Dmd Pa | |
|
2 Rancocas Blvd Mount Laurel NJ 08054-2057 | |
| (856) 778-8655 | |
| Not Available |
| Full Name | Bradley J Convissar Dmd Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2 Rancocas Blvd, Mount Laurel, New Jersey |
| Authorized Official Name and Position | Bradley J Convissar (PRESIDENT) |
| Authorized Official Contact | 8567788655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley J Convissar Dmd Pa 2 Rancocas Blvd Mount Laurel NJ 08054-2057 Ph: (856) 778-8655 | Bradley J Convissar Dmd Pa 2 Rancocas Blvd Mount Laurel NJ 08054-2057 Ph: (856) 778-8655 |
| NPI Number | 1316607757 |
|---|---|
| Provider Enumeration Date | 12/27/2021 |
| Last Update Date | 12/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316607757 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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