Healthcare Provider Details

I. General information

NPI: 1033146048
Provider Name (Legal Business Name): DAWN CAROL ENGLERT RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 PROGRESS ST SUITE B-1
EDISON NJ
08820-1199
US

IV. Provider business mailing address

4 PROGRESS ST SUITE B-1
EDISON NJ
08820-1199
US

V. Phone/Fax

Practice location:
  • Phone: 908-757-3191
  • Fax: 908-757-0129
Mailing address:
  • Phone: 908-757-3191
  • Fax: 908-757-0129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number22HI00170000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: