Healthcare Provider Details

I. General information

NPI: 1811447527
Provider Name (Legal Business Name): BEDMINSTER DENTAL & SPECIALTY GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2016
Last Update Date: 10/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 US HIGHWAY 202 206 2ND FLOOR
BEDMINSTER NJ
07921-1514
US

IV. Provider business mailing address

432 US HIGHWAY 202 206 2ND FLOOR
BEDMINSTER NJ
07921-1514
US

V. Phone/Fax

Practice location:
  • Phone: 908-470-2200
  • Fax: 908-470-2201
Mailing address:
  • Phone: 908-470-2200
  • Fax: 908-470-2201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI02175000
License Number StateNJ

VIII. Authorized Official

Name: DR. TODD SINGER
Title or Position: OWNER
Credential: 22DI02175000
Phone: 609-252-9000