| Kenilworth Dental Associates, Llc | |
|
513 Boulevard Kenilworth NJ 07033-1637 | |
| (908) 276-6652 | |
| (908) 709-4337 |
| Full Name | Kenilworth Dental Associates, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 513 Boulevard, Kenilworth, New Jersey |
| Authorized Official Name and Position | Jerome Scott Forman (OWNER) |
| Authorized Official Contact | 9082766652 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenilworth Dental Associates, Llc 513 Boulevard Kenilworth NJ 07033-1637 Ph: (908) 276-6652 | Kenilworth Dental Associates, Llc 513 Boulevard Kenilworth NJ 07033-1637 Ph: (908) 276-6652 |
| NPI Number | 1710064977 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710064977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 14638 (New Jersey) | Primary |
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