Provider Demographics
NPI:1760400501
Name:CEDARBAUM, ANDREW (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:CEDARBAUM
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MAIN ST
Mailing Address - Street 2:PO BOX 223
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1468
Mailing Address - Country:US
Mailing Address - Phone:908-782-5444
Mailing Address - Fax:908-782-1965
Practice Address - Street 1:8 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1468
Practice Address - Country:US
Practice Address - Phone:908-782-5444
Practice Address - Fax:908-782-1965
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI018614001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics