Provider Demographics
NPI:1760714984
Name:CARING DENTAL SOUTH
Entity Type:Organization
Organization Name:CARING DENTAL SOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:PRASAD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-462-5700
Mailing Address - Street 1:7 SCHOOL RD E
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-2007
Mailing Address - Country:US
Mailing Address - Phone:732-462-5700
Mailing Address - Fax:
Practice Address - Street 1:7 SCHOOL RD E
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-2007
Practice Address - Country:US
Practice Address - Phone:732-462-5700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-13
Last Update Date:2010-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ13595122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5088101Medicaid