Provider Demographics
NPI:1437637337
Name:CORNERSTONE DENTAL OF GREEN BROOK
Entity Type:Organization
Organization Name:CORNERSTONE DENTAL OF GREEN BROOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-742-9615
Mailing Address - Street 1:314 US HWY 22 WEST
Mailing Address - Street 2:SUITE D
Mailing Address - City:GREEN BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08812-1700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:314 US HWY 22 WEST
Practice Address - Street 2:SUITE D
Practice Address - City:GREEN BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08812-1700
Practice Address - Country:US
Practice Address - Phone:732-424-8483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental