| Eastern Dental Of Ewing, Llc | |
|
1330 Parkway Ave Ewing NJ 08628-3006 | |
| (609) 883-0801 | |
| Not Available |
| Full Name | Eastern Dental Of Ewing, Llc |
|---|---|
| Speciality | Dentist |
| Location | 1330 Parkway Ave, Ewing, New Jersey |
| Authorized Official Name and Position | Michael Slomovitz (DIRECTOR) |
| Authorized Official Contact | 6098830801 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Dental Of Ewing, Llc 1030 Saint Georges Ave Avenel NJ 07001-1390 Ph: () - | Eastern Dental Of Ewing, Llc 1330 Parkway Ave Ewing NJ 08628-3006 Ph: (609) 883-0801 |
| NPI Number | 1861540965 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0345534764 |
|---|---|
| Medicare Enrollment ID | O20160809000069 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861540965 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10804 (New Jersey) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 10967 (New Jersey) | Primary |
| Provider Name | Michael Kovall |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1194849091 PECOS PAC ID: 0244526853 Enrollment ID: I20160908000826 |
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