Epp New Jersey Llc | |
71 Valley St Ste 100 South Orange NJ 07079-2825 | |
(862) 250-6952 | |
Not Available |
Full Name | Epp New Jersey Llc |
---|---|
Speciality | Dentist - Endodontics |
Location | 71 Valley St Ste 100, South Orange, New Jersey |
Authorized Official Name and Position | Jason Bertollini (CREDENTIALING MANAGER) |
Authorized Official Contact | 3154500763 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Epp New Jersey Llc Po Box 1584 Brentwood TN 37024-1584 Ph: (315) 450-0763 | Epp New Jersey Llc 71 Valley St Ste 100 South Orange NJ 07079-2825 Ph: (862) 250-6952 |
NPI Number | 1194546770 |
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Provider Enumeration Date | 10/17/2024 |
Last Update Date | 10/17/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194546770 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223E0200X | Dentist - Endodontics | (* (Not Available)) | Primary |
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