Provider Demographics
NPI:1134255326
Name:PROSTHODONTIC ASSOCIATES OF CENTRAL JERSEY, L.L.C.
Entity type:Organization
Organization Name:PROSTHODONTIC ASSOCIATES OF CENTRAL JERSEY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:ROSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-422-7440
Mailing Address - Street 1:2186 STATE ROUTE 27
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1137
Mailing Address - Country:US
Mailing Address - Phone:732-422-7440
Mailing Address - Fax:732-422-7445
Practice Address - Street 1:2186 STATE ROUTE 27
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1137
Practice Address - Country:US
Practice Address - Phone:732-422-7440
Practice Address - Fax:732-422-7445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-24
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty