| Dental Star | |
|
74 Phillip Ln Manalapan NJ 07726-8335 | |
| (732) 972-7770 | |
| (732) 972-7705 |
| Full Name | Dental Star |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 74 Phillip Ln, Manalapan, New Jersey |
| Authorized Official Name and Position | Vladimir Potepalov (DENTIST) |
| Authorized Official Contact | 7329727770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Star 74 Philip Plaza Unit C Englishtown NJ 07726 Ph: (732) 972-7770 | Dental Star 74 Phillip Ln Manalapan NJ 07726-8335 Ph: (732) 972-7770 |
| NPI Number | 1942471586 |
|---|---|
| Provider Enumeration Date | 03/21/2008 |
| Last Update Date | 04/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942471586 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 22DI02284000 (New Jersey) | Primary |
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