| Eastern Periodontic Associates, Llc | |
|
1030 Saint Georges Ave Avenel NJ 07001-1390 | |
| (732) 750-3600 | |
| (732) 750-3696 |
| Full Name | Eastern Periodontic Associates, Llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1030 Saint Georges Ave, Avenel, New Jersey |
| Authorized Official Name and Position | Aaron Prestup (DIRECTOR OF PERIODONTICS) |
| Authorized Official Contact | 7327503600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Periodontic Associates, Llc 1030 Saint Georges Ave Avenel NJ 07001-1390 Ph: () - | Eastern Periodontic Associates, Llc 1030 Saint Georges Ave Avenel NJ 07001-1390 Ph: (732) 750-3600 |
| NPI Number | 1093876658 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093876658 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 09460 (New Jersey) | Primary |
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