Healthcare Provider Details

I. General information

NPI: 1720138464
Provider Name (Legal Business Name): APEX DENTAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 PARKWAY AVE LEXINGTON MEWS, SUITE A-5
EWING NJ
08618-2704
US

IV. Provider business mailing address

795 PARKWAY AVE LEXINGTON MEWS, SUITE A-5
EWING NJ
08618-2704
US

V. Phone/Fax

Practice location:
  • Phone: 609-771-0032
  • Fax: 609-771-6028
Mailing address:
  • Phone: 609-771-0032
  • Fax: 609-771-6028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI02155600
License Number StateNJ

VIII. Authorized Official

Name: MISS IVONA KOPANJA
Title or Position: OFFICE MANAGER
Credential:
Phone: 609-771-0032