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General NPI Number Information
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NPI Number | 1841377298
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Entity Type | Organization
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Legal Business Name | LIFE FAMILY DENTAL
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 403 US HIGHWAY 202
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City | FLEMINGTON
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State | NJ
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Zip | 08822-6037
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Country | US
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Telephone | 908-782-4443
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Fax | 908-782-4443
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Provider Business Mailing Address
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Address Line | 403 US HIGHWAY 202
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City | FLEMINGTON
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State | NJ
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Zip | 08822-6037
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Country | US
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Telephone | 908-782-4443
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Fax | 908-782-4443
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Authorized Official
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Title or Position | CEO
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Name | DR. MICHAEL LEYFERMAN
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Credential | D.M.D.
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Telephone | 908-782-4443
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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 | DI21481
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License Number State | NJ
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