| Gd Nj Randolph Llc | |
|
2 W Hanover Ave Ste 201 Randolph NJ 07869-4222 | |
| (973) 895-5111 | |
| Not Available |
| Full Name | Gd Nj Randolph Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2 W Hanover Ave Ste 201, Randolph, New Jersey |
| Authorized Official Name and Position | Chad Hendricks (CREDENTIALING) |
| Authorized Official Contact | 6128590444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gd Nj Randolph Llc 2 W Hanover Ave Ste 201 Randolph NJ 07869-4222 Ph: (973) 895-5111 | Gd Nj Randolph Llc 2 W Hanover Ave Ste 201 Randolph NJ 07869-4222 Ph: (973) 895-5111 |
| NPI Number | 1003689233 |
|---|---|
| Provider Enumeration Date | 10/31/2023 |
| Last Update Date | 10/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003689233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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