Provider Demographics
NPI:1376600122
Name:ENDODONTIC ASSOC. OF S.J., PA.
Entity Type:Organization
Organization Name:ENDODONTIC ASSOC. OF S.J., PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:A
Authorized Official - Last Name:STERLING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:609-653-1111
Mailing Address - Street 1:810 NEW RD
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1105
Mailing Address - Country:US
Mailing Address - Phone:609-653-1111
Mailing Address - Fax:609-653-6247
Practice Address - Street 1:810 NEW RD
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1105
Practice Address - Country:US
Practice Address - Phone:609-653-1111
Practice Address - Fax:609-653-6247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA125051223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty