Healthcare Provider Details
I. General information
NPI: 1275001158
Provider Name (Legal Business Name): RBGS PARTNERS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/08/2018
Last Update Date: 11/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
440 FRONT STREET
ELMER NJ
08318
US
IV. Provider business mailing address
440 FRONT ST
ELMER NJ
08318-2177
US
V. Phone/Fax
- Phone: 856-358-8303
- Fax:
- Phone: 856-358-8318
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
GREGORY
WILLIAM
STRAIT
Title or Position: OWNER
Credential: DMD
Phone: 267-334-0082