| South Avenue Dental Group | |
|
104 South Ave E Cranford NJ 07016-2944 | |
| (203) 889-5379 | |
| Not Available |
| Full Name | South Avenue Dental Group |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 104 South Ave E, Cranford, New Jersey |
| Authorized Official Name and Position | Lajja Patel (OWNER) |
| Authorized Official Contact | 2038895379 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Avenue Dental Group 1106 Grandview Ave Westfield NJ 07090-1661 Ph: (646) 483-8824 | South Avenue Dental Group 104 South Ave E Cranford NJ 07016-2944 Ph: (203) 889-5379 |
| NPI Number | 1285204347 |
|---|---|
| Provider Enumeration Date | 06/30/2021 |
| Last Update Date | 06/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285204347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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