Provider Demographics
NPI:1508298696
Name:ECKERT, EVELYN (DMD)
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:
Last Name:ECKERT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 TROY HILLS RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-1538
Mailing Address - Country:US
Mailing Address - Phone:973-952-1005
Mailing Address - Fax:973-884-4002
Practice Address - Street 1:12 TROY HILLS RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-1538
Practice Address - Country:US
Practice Address - Phone:973-952-1005
Practice Address - Fax:973-884-4002
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI015331001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics