| Garden State Orofacial Pain Llc | |
|
258 Broad St Red Bank NJ 07701-2035 | |
| (732) 345-1800 | |
| Not Available |
| Full Name | Garden State Orofacial Pain Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 258 Broad St, Red Bank, New Jersey |
| Authorized Official Name and Position | Sowmya Ananthan (MEMBER) |
| Authorized Official Contact | 7323451800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Garden State Orofacial Pain Llc 26 Renoir Dr Monmouth Junction NJ 08852-2543 Ph: (732) 345-1800 | Garden State Orofacial Pain Llc 258 Broad St Red Bank NJ 07701-2035 Ph: (732) 345-1800 |
| NPI Number | 1477906592 |
|---|---|
| Provider Enumeration Date | 07/14/2016 |
| Last Update Date | 07/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477906592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DI24531 (New Jersey) | Primary |
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