Healthcare Provider Details

I. General information

NPI: 1992712004
Provider Name (Legal Business Name): MONROE DENTAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 PERRINEVILLE RD SUITE D
MONROE TOWNSHIP NJ
08831-4923
US

IV. Provider business mailing address

1600 PERRINEVILLE RD SUITE D
MONROE TOWNSHIP NJ
08831-4923
US

V. Phone/Fax

Practice location:
  • Phone: 609-655-3551
  • Fax: 609-409-1138
Mailing address:
  • Phone: 609-655-3551
  • Fax: 609-409-1138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number10577
License Number StateNJ

VIII. Authorized Official

Name: DR. LAWRENCE KLEIN
Title or Position: CO-OWNER
Credential: DDS
Phone: 609-655-3551