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General NPI Number Information
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NPI Number | 1821325101
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Entity Type | Organization
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Legal Business Name | EDISON DENTAL CARE P.C.
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Dates
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Enumeration Date | 11/07/2009
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Last Update Date | 11/07/2009
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Provider Practice Location Address
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Address Line | 257 BRIDGE ST
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City | METUCHEN
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State | NJ
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Zip | 08840-2294
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Country | US
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Telephone | 848-260-0538
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Fax | 848-260-0539
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Provider Business Mailing Address
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Address Line | 257 BRIDGE ST
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City | METUCHEN
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State | NJ
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Zip | 08840-2294
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Country | US
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Telephone | 848-260-0538
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Fax | 848-260-0539
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES LEUNG
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Credential | DDS
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Telephone | 848-260-0538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DI021771
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License Number State | NJ
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