Provider Demographics
NPI:1053443150
Name:FORTE, ERIC JOSEPH (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JOSEPH
Last Name:FORTE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CARTER LN
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-5578
Mailing Address - Country:US
Mailing Address - Phone:856-810-2088
Mailing Address - Fax:
Practice Address - Street 1:59 LAKEVIEW DR N
Practice Address - Street 2:
Practice Address - City:GIBBSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08026-1002
Practice Address - Country:US
Practice Address - Phone:856-784-7900
Practice Address - Fax:856-784-5904
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ21996122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist