Provider Demographics
NPI:1497129332
Name:HUNTERDON ENDODONTICS, P.A.
Entity Type:Organization
Organization Name:HUNTERDON ENDODONTICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:JIORLE
Authorized Official - Last Name:ARCHIBLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-341-9428
Mailing Address - Street 1:1465 ROUTE 31 S
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08801-3129
Mailing Address - Country:US
Mailing Address - Phone:201-341-9428
Mailing Address - Fax:
Practice Address - Street 1:1 STURBRIDGE CT
Practice Address - Street 2:
Practice Address - City:GLEN GARDNER
Practice Address - State:NJ
Practice Address - Zip Code:08826-3344
Practice Address - Country:US
Practice Address - Phone:201-341-9428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02343600261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental