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General NPI Number Information
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NPI Number | 1245457001
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Entity Type | Individual
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Provider Name | VICTOR H. TRAIN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 390 STATE ROUTE 10 SUITE 102
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City | RANDOLPH
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State | NJ
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Zip | 07869-2141
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Country | US
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Telephone | 973-361-6180
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Fax | 973-361-6087
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Provider Business Mailing Address
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Address Line | 390 STATE ROUTE 10 SUITE 102
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City | RANDOLPH
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State | NJ
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Zip | 07869-2141
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Country | US
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Telephone | 973-361-6180
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Fax | 973-361-6087
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 13089
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License Number State | NJ
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