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NPI Code Detail

MEDICARE: DR. LARRY MORRIS EDELMAN D.D.S.

MEDICARE: DR. LARRY MORRIS EDELMAN D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDI010761NJ

General Provider Information

NPI Number : 1992797310
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LARRY MORRIS EDELMAN D.D.S.
Provider Business Mailing Address
First Line : 369 W BLACKWELL ST
Second Line :
City : DOVER
State : NJ
Zip : 07801-2560
Country : US
Telephone Number : 973-328-1225
Fax Number :
Provider Business Practice Location Address
First Line : 369 W BLACKWELL ST
Second Line :
City : DOVER
State : NJ
Zip : 07801-2560
Country : US
Telephone Number : 973-328-1225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 07/08/2007

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