Provider Demographics
NPI:1235208836
Name:KONDOROSSY, COLOMAN E (DMD FAGD)
Entity Type:Individual
Prefix:DR
First Name:COLOMAN
Middle Name:E
Last Name:KONDOROSSY
Suffix:
Gender:M
Credentials:DMD FAGD
Other - Prefix:
Other - First Name:KALMAN
Other - Middle Name:
Other - Last Name:KONDOROSSY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1445 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873
Mailing Address - Country:US
Mailing Address - Phone:732-249-6304
Mailing Address - Fax:732-249-6304
Practice Address - Street 1:1445 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873
Practice Address - Country:US
Practice Address - Phone:732-249-6304
Practice Address - Fax:732-249-6304
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI160851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice