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General NPI Number Information
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NPI Number | 1003083049
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER J CONNOLLY DMD,PA
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Dates
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Enumeration Date | 05/09/2008
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Last Update Date | 12/27/2016
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Provider Practice Location Address
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Address Line | 379 EGG HARBOR RD
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City | SEWELL
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State | NJ
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Zip | 08080-1853
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Country | US
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Telephone | 856-582-0090
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Fax | 856-582-5747
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Provider Business Mailing Address
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Address Line | 379 EGG HARBOR RD
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City | SEWELL
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State | NJ
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Zip | 08080-1853
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Country | US
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Telephone | 856-582-0090
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Fax | 856-582-5747
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. CHRISTOPHER JAMES CONNOLLY
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Credential | DMD
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Telephone | 856-582-0090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI01228000
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License Number State | NJ
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