Provider Demographics
NPI:1285843573
Name:COYLE, DENNIS G (DMD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:G
Last Name:COYLE
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 1:55 VAN HOLTEN RD
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-3438
Mailing Address - Country:US
Mailing Address - Phone:908-626-0775
Mailing Address - Fax:
Practice Address - Street 1:8 SHUNPIKE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-2740
Practice Address - Country:US
Practice Address - Phone:973-966-6555
Practice Address - Fax:973-966-6321
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ121041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice