| Rudolph R Leidl Dmd Facd Pa | |
|
2 Mountain View Ave Long Valley NJ 07853 | |
| (908) 876-3458 | |
| (908) 876-9121 |
| Full Name | Rudolph R Leidl Dmd Facd Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2 Mountain View Ave, Long Valley, New Jersey |
| Authorized Official Name and Position | Rudolph R Leidl (OWNER PRESIDENT) |
| Authorized Official Contact | 9088763458 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rudolph R Leidl Dmd Facd Pa 2 Mountain View Ave Long Valley NJ 07853 Ph: (908) 876-3458 | Rudolph R Leidl Dmd Facd Pa 2 Mountain View Ave Long Valley NJ 07853 Ph: (908) 876-3458 |
| NPI Number | 1194895466 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194895466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 22DI01106300 (New Jersey) | Primary |
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