| Eastern Dental Of Lacey, Llc | |
|
131 S Main St Forked River NJ 08731-3635 | |
| (609) 693-6066 | |
| Not Available |
| Full Name | Eastern Dental Of Lacey, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 131 S Main St, Forked River, New Jersey |
| Authorized Official Name and Position | Andrew Dubman (DIRECTOR) |
| Authorized Official Contact | 6096936066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Dental Of Lacey, Llc 1030 Saint Georges Ave Avenel NJ 07001-1390 Ph: () - | Eastern Dental Of Lacey, Llc 131 S Main St Forked River NJ 08731-3635 Ph: (609) 693-6066 |
| NPI Number | 1689722787 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689722787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 17953 (New Jersey) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 10967 (New Jersey) | Primary |
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