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General NPI Number Information
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NPI Number | 1699885194
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Entity Type | Organization
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Legal Business Name | GARY A. CORTINA,D.M.D.,P.A.
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2510 NOTTINGHAM WAY
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City | MERCERVILLE
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State | NJ
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Zip | 08619-4113
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Country | US
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Telephone | 609-587-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 34 MEADOW LN
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City | PENNINGTON
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State | NJ
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Zip | 08534-2113
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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/OWNER
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Name | DR. GARY ANTHONY CORTINA
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Credential | D.M.D.
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Telephone | 609-587-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 10828
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License Number State | NJ
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