Provider Demographics
NPI:1942315395
Name:ROCKFORD, EDWARD ROBERT (DMD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ROBERT
Last Name:ROCKFORD
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 1:60 OLD DENVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005-8835
Mailing Address - Country:US
Mailing Address - Phone:973-335-6384
Mailing Address - Fax:973-993-1929
Practice Address - Street 1:89 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6816
Practice Address - Country:US
Practice Address - Phone:973-993-8303
Practice Address - Fax:973-993-1929
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ117341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice