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General NPI Number Information
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NPI Number | 1427758564
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Entity Type | Organization
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Legal Business Name | PRIME CARE DENTAL LLC
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Dates
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Enumeration Date | 03/07/2023
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1 WASHINGTON BLVD STE 8
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City | ROBBINSVILLE
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State | NJ
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Zip | 08691-3162
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Country | US
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Telephone | 609-490-1616
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Fax |
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Provider Business Mailing Address
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Address Line | 1 WASHINGTON BLVD STE 8
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City | ROBBINSVILLE
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State | NJ
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Zip | 08691-3162
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Country | US
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Telephone | 609-490-1616
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. KEYUR MODI
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Credential | DMD
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Telephone | 201-755-1525
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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 |
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