| Elbasty Pediatric An Denta Assoc. | |
|
100 Commons Way Suite 130 Holmdel NJ 07733 | |
| (732) 615-0700 | |
| Not Available |
| Full Name | Elbasty Pediatric An Denta Assoc. |
|---|---|
| Speciality | Dentist |
| Location | 100 Commons Way, Holmdel, New Jersey |
| Authorized Official Name and Position | Mohamed A. Elbasty (PRESIDENT) |
| Authorized Official Contact | 7326150700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elbasty Pediatric An Denta Assoc. 100 Commons Way Suite 130 Holmdel NJ 07733 Ph: () - | Elbasty Pediatric An Denta Assoc. 100 Commons Way Suite 130 Holmdel NJ 07733 Ph: (732) 615-0700 |
| NPI Number | 1487883559 |
|---|---|
| Provider Enumeration Date | 07/09/2009 |
| Last Update Date | 07/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487883559 | NPI | - | NPPES |
| 0023035 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 19874 (New Jersey) | Primary |
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