Provider Demographics
NPI:1922260991
Name:LATEINER, MICHAEL P (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:LATEINER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 ROUTE 206
Mailing Address - Street 2:SUITE 305
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-9189
Mailing Address - Country:US
Mailing Address - Phone:973-927-2260
Mailing Address - Fax:973-927-8356
Practice Address - Street 1:230 ROUTE 206
Practice Address - Street 2:SUITE 305
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9189
Practice Address - Country:US
Practice Address - Phone:973-927-2260
Practice Address - Fax:973-927-8356
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02286400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist