| Gerard L. Gonsalves, Dmd, Pa | |
|
2168 Millburn Ave Suite 102 Maplewood NJ 07040-2640 | |
| (973) 763-1300 | |
| (973) 763-0800 |
| Full Name | Gerard L. Gonsalves, Dmd, Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2168 Millburn Ave, Maplewood, New Jersey |
| Authorized Official Name and Position | Gerard L. Gonsalves (OWNER) |
| Authorized Official Contact | 9737631300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gerard L. Gonsalves, Dmd, Pa 2168 Millburn Ave Suite 102 Maplewood NJ 07040-2640 Ph: (973) 763-1300 | Gerard L. Gonsalves, Dmd, Pa 2168 Millburn Ave Suite 102 Maplewood NJ 07040-2640 Ph: (973) 763-1300 |
| NPI Number | 1043272040 |
|---|---|
| Provider Enumeration Date | 04/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043272040 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DI01640700 (New Jersey) | Primary |
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