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General NPI Number Information
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NPI Number | 1003965690
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Entity Type | Individual
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Provider Name | SUSAN B. TARNOFSKY D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 35 FADEM RD
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City | SPRINGFIELD
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State | NJ
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Zip | 07081-3115
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Country | US
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Telephone | 973-379-1120
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Fax |
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Provider Business Mailing Address
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Address Line | 78 WINDING WAY
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City | WEST ORANGE
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State | NJ
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Zip | 07052-3800
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Country | US
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Telephone | 973-669-1599
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 |
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License Number State | NJ
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