| Gerald S. Convissar Dds Pa | |
|
2 Rancocas Blvd Mount Laurel NJ 08054-2057 | |
| (856) 778-8655 | |
| (856) 231-7480 |
| Full Name | Gerald S. Convissar Dds Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2 Rancocas Blvd, Mount Laurel, New Jersey |
| Authorized Official Name and Position | Gerald S Convissar (PRESIDENT) |
| Authorized Official Contact | 8567788655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gerald S. Convissar Dds Pa 1373 Heartwood Dr Cherry Hill NJ 08003-2741 Ph: (856) 778-8655 | Gerald S. Convissar Dds Pa 2 Rancocas Blvd Mount Laurel NJ 08054-2057 Ph: (856) 778-8655 |
| NPI Number | 1750443206 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750443206 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 22DI01196800 (New Jersey) | Primary |
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