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General NPI Number Information
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NPI Number | 1790338952
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Entity Type | Organization
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Legal Business Name | TROY MEADOWS DENTAL PC
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Dates
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Enumeration Date | 07/17/2019
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Last Update Date | 04/02/2020
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Provider Practice Location Address
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Address Line | 488 N BEVERWYCK RD STE B
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City | LAKE HIAWATHA
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State | NJ
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Zip | 07034-2511
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Country | US
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Telephone | 973-860-9724
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Fax | 973-860-9774
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Provider Business Mailing Address
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Address Line | 488 N BEVERWYCK RD STE B
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City | LAKE HIAWATHA
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State | NJ
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Zip | 07034-2511
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Country | US
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Telephone | 973-860-9724
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Fax | 973-860-9773
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ADITYA PRASHAD GUPTA
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Credential | DDS
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Telephone | 973-860-9724
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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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