Glen Ridge Cosmetic And Family Dentistry | |
89 Glen Ridge Ave Glen Ridge NJ 07028-1413 | |
(973) 743-6092 | |
Not Available |
Full Name | Glen Ridge Cosmetic And Family Dentistry |
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Speciality | Dentist |
Location | 89 Glen Ridge Ave, Glen Ridge, New Jersey |
Authorized Official Name and Position | Louis Theodorou (OWNER) |
Authorized Official Contact | 9737436092 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Glen Ridge Cosmetic And Family Dentistry 89 Glen Ridge Ave Glen Ridge NJ 07028-1413 Ph: (973) 743-6092 | Glen Ridge Cosmetic And Family Dentistry 89 Glen Ridge Ave Glen Ridge NJ 07028-1413 Ph: (973) 743-6092 |
NPI Number | 1083880819 |
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Provider Enumeration Date | 05/01/2008 |
Last Update Date | 05/01/2008 |
Identifier | Type | State | Issuer |
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1083880819 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 21675 (New Jersey) | Primary |