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General NPI Number Information
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NPI Number | 1760493142
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Entity Type | Organization
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Legal Business Name | DENTAL ARTS OF WOODBRIDGE LLP
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 871 ST GEORGES AVE
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-2514
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Country | US
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Telephone | 732-634-5200
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Fax | 732-634-1214
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Provider Business Mailing Address
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Address Line | 871 ST GEORGES AVE
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-2514
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Country | US
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Telephone | 732-634-5200
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Fax | 732-634-1214
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Authorized Official
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Title or Position | OWNER PARTNER
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Name | STEPHEN CANDELL
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Credential | DDS
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Telephone | 732-634-5200
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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 | 22DI02222103
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License Number State | NJ
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