Provider Demographics
NPI:1720157126
Name:ROGER LERNER DMD LLC
Entity Type:Organization
Organization Name:ROGER LERNER DMD LLC
Other - Org Name:ROGER LERNER DMD FAMILY, COSMETIC&IMPLANT DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:LERNER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-651-1818
Mailing Address - Street 1:2A AUER COURT
Mailing Address - Street 2:WILLIAMSBURG COMMONS
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816
Mailing Address - Country:US
Mailing Address - Phone:732-651-1818
Mailing Address - Fax:732-651-9747
Practice Address - Street 1:2A AUER COURT
Practice Address - Street 2:WILLIAMSBURG COMMONS
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816
Practice Address - Country:US
Practice Address - Phone:732-651-1818
Practice Address - Fax:732-651-9747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 204701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty