Healthcare Provider Details

I. General information

NPI: 1356430177
Provider Name (Legal Business Name): DAVID ROMISHER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 W PARK AVE
MERCHANTVILLE NJ
08109-2204
US

IV. Provider business mailing address

7 W PARK AVE
MERCHANTVILLE NJ
08109-2204
US

V. Phone/Fax

Practice location:
  • Phone: 856-663-4510
  • Fax: 856-663-5852
Mailing address:
  • Phone: 856-663-4510
  • Fax: 856-663-5852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDI 017529
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: