Provider Demographics
NPI:1831281807
Name:SUNDARESH, SABITHA B (DDS)
Entity Type:Individual
Prefix:
First Name:SABITHA
Middle Name:B
Last Name:SUNDARESH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 GROVE AVENUE
Mailing Address - Street 2:GROVE DENTAL CARE
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3225
Mailing Address - Country:US
Mailing Address - Phone:732-549-6082
Mailing Address - Fax:732-549-8916
Practice Address - Street 1:652 GROVE AVENUE
Practice Address - Street 2:GROVE DENTAL CARE
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3225
Practice Address - Country:US
Practice Address - Phone:732-549-6082
Practice Address - Fax:732-549-8916
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI211811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice