Provider Demographics
NPI:1770141624
Name:MCARDLE, CHRISTINA ROSE (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:ROSE
Last Name:MCARDLE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MACLEISH DR
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1559
Mailing Address - Country:US
Mailing Address - Phone:732-713-5196
Mailing Address - Fax:
Practice Address - Street 1:2022 STATE ROUTE 71 STE 102
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07762-2291
Practice Address - Country:US
Practice Address - Phone:732-974-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-04
Last Update Date:2020-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ22DI02787300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program