| Advaced Dental Associates Of South Orange | |
|
45 Prospect St South Orange NJ 07079-2100 | |
| (973) 763-2940 | |
| (973) 763-0906 |
| Full Name | Advaced Dental Associates Of South Orange |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 45 Prospect St, South Orange, New Jersey |
| Authorized Official Name and Position | Steven Koretzky (VICE PRESIDENT) |
| Authorized Official Contact | 9737632940 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advaced Dental Associates Of South Orange 41 Wyckoff Dr Pittstown NJ 08867-4235 Ph: (973) 763-2940 | Advaced Dental Associates Of South Orange 45 Prospect St South Orange NJ 07079-2100 Ph: (973) 763-2940 |
| NPI Number | 1386773844 |
|---|---|
| Provider Enumeration Date | 03/02/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386773844 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 22DI01951600 (New Jersey) | Primary |
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