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General NPI Number Information
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NPI Number | 1376600122
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Entity Type | Organization
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Legal Business Name | ENDODONTIC ASSOC. OF S.J., PA.
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 810 NEW RD
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City | LINWOOD
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State | NJ
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Zip | 08221-1105
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Country | US
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Telephone | 609-653-1111
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Fax | 609-653-6247
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Provider Business Mailing Address
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Address Line | 810 NEW RD
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City | LINWOOD
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State | NJ
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Zip | 08221-1105
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Country | US
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Telephone | 609-653-1111
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Fax | 609-653-6247
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Authorized Official
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Title or Position | DENTIST
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Name | DR. RAYMOND A. STERLING
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Credential | D.D.S.
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Telephone | 609-653-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 12505
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License Number State | WA
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