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General NPI Number Information
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NPI Number | 1083575765
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Entity Type | Organization
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Legal Business Name | ADVANCED DENTISTRY OF SOMERSET LLC
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Dates
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Enumeration Date | 11/21/2025
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 1130 US HIGHWAY 202
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City | RARITAN
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State | NJ
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Zip | 08869-1490
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Country | US
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Telephone | 908-722-8256
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Fax |
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Provider Business Mailing Address
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Address Line | 68 BRADHURST AVE APT 7D
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City | NEW YORK
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State | NY
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Zip | 10039-3309
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | REBECCA KUCHARSKY HIESS
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Credential | DMD
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Telephone | 617-901-6091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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