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General NPI Number Information
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NPI Number | 1558565010
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Entity Type | Organization
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Legal Business Name | CHACKER & CHACKER PA
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6 COLONIAL LAKE DR
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-4126
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Country | US
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Telephone | 609-883-6900
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Fax | 609-883-2785
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Provider Business Mailing Address
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Address Line | 6 COLONIAL LAKE DR
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-4126
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Country | US
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Telephone | 609-883-6900
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Fax | 609-883-2785
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. LAURENCE G CHAKCER
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Credential |
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Telephone | 609-883-6900
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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 | DI16170
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License Number State | NJ
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