Provider Demographics
NPI:1235348665
Name:EXCELDENT DENTAL OF NEW BRUNSWICK, LLP
Entity Type:Organization
Organization Name:EXCELDENT DENTAL OF NEW BRUNSWICK, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:DODD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-828-5750
Mailing Address - Street 1:322 LIVINGSTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901
Mailing Address - Country:US
Mailing Address - Phone:732-828-5750
Mailing Address - Fax:732-828-5751
Practice Address - Street 1:322 LIVINGSTON AVENUE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901
Practice Address - Country:US
Practice Address - Phone:732-828-5750
Practice Address - Fax:732-828-5751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty