Provider Demographics
NPI:1255746343
Name:BRIM, CAITLYN ZUDANS (DMD)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:ZUDANS
Last Name:BRIM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:
Other - Last Name:ZUDANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1303 MOUNT HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-3733
Mailing Address - Country:US
Mailing Address - Phone:609-386-5700
Mailing Address - Fax:
Practice Address - Street 1:1303 MOUNT HOLLY RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-3733
Practice Address - Country:US
Practice Address - Phone:609-386-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02574600122300000X
PADS040072122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist