| Glen Ridge Cosmetic And Family Dentistry | |
|
89 Glen Ridge Ave Glen Ridge NJ 07028-1413 | |
| (973) 743-6092 | |
| Not Available |
| Full Name | Glen Ridge Cosmetic And Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 89 Glen Ridge Ave, Glen Ridge, New Jersey |
| Authorized Official Name and Position | Louis Theodorou (OWNER) |
| Authorized Official Contact | 9737436092 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glen Ridge Cosmetic And Family Dentistry 89 Glen Ridge Ave Glen Ridge NJ 07028-1413 Ph: (973) 743-6092 | Glen Ridge Cosmetic And Family Dentistry 89 Glen Ridge Ave Glen Ridge NJ 07028-1413 Ph: (973) 743-6092 |
| NPI Number | 1083880819 |
|---|---|
| Provider Enumeration Date | 05/01/2008 |
| Last Update Date | 05/01/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083880819 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 21675 (New Jersey) | Primary |