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General NPI Number Information
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NPI Number | 1407407877
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Entity Type | Organization
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Legal Business Name | ADVANCED DENTAL CARE AT BRIDGEWATER LLC
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Dates
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Enumeration Date | 09/26/2019
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Last Update Date | 11/20/2019
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Provider Practice Location Address
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Address Line | 678 US 206 BUILDING 5 UNIT 8
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City | BRIDGEWATER
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State | NJ
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Zip | 08807
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Country | US
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Telephone | 908-838-0198
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Fax |
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Provider Business Mailing Address
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Address Line | 678 US 206 BUILDING 5, UNIT 8
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City | BRIDGEWATER
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State | NJ
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Zip | 08807
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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 | PRESIDENT
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Name | YAU-TING LAM
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Credential | DDS
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Telephone | 908-838-0198
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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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