Provider Demographics
NPI:1780208645
Name:ADVANCED DENTAL ARTS OF SOUTH BRUNSWICK, P.A.
Entity Type:Organization
Organization Name:ADVANCED DENTAL ARTS OF SOUTH BRUNSWICK, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:K
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-422-0068
Mailing Address - Street 1:3176 STATE ROUTE 27 STE 2C
Mailing Address - Street 2:
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824-1514
Mailing Address - Country:US
Mailing Address - Phone:732-422-0068
Mailing Address - Fax:732-419-3889
Practice Address - Street 1:3176 STATE ROUTE 27 STE 2C
Practice Address - Street 2:
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824-1514
Practice Address - Country:US
Practice Address - Phone:732-422-0068
Practice Address - Fax:732-419-3889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty