Provider Demographics
NPI:1720138464
Name:APEX DENTAL CARE, LLC
Entity Type:Organization
Organization Name:APEX DENTAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:IVONA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPANJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-771-0032
Mailing Address - Street 1:795 PARKWAY AVE
Mailing Address - Street 2:LEXINGTON MEWS, SUITE A-5
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-2704
Mailing Address - Country:US
Mailing Address - Phone:609-771-0032
Mailing Address - Fax:609-771-6028
Practice Address - Street 1:795 PARKWAY AVE
Practice Address - Street 2:LEXINGTON MEWS, SUITE A-5
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-2704
Practice Address - Country:US
Practice Address - Phone:609-771-0032
Practice Address - Fax:609-771-6028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI021556001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty