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1200 Lawrenceville Rd Suite 2 Lawrenceville NJ 08648-3551 | |
| (609) 883-1770 | |
| (609) 883-1777 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1200 Lawrenceville Rd, Lawrenceville, New Jersey |
| Authorized Official Name and Position | Charles J Rose (OWNER) |
| Authorized Official Contact | 6098831770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1200 Lawrenceville Rd Suite 2 Lawrenceville NJ 08648-3551 Ph: (609) 883-1770 | 1200 Lawrenceville Rd Suite 2 Lawrenceville NJ 08648-3551 Ph: (609) 883-1770 |
| NPI Number | 1114216496 |
|---|---|
| Provider Enumeration Date | 04/07/2011 |
| Last Update Date | 04/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114216496 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 22DI01462203 (New Jersey) | Primary |
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