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General NPI Number Information
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NPI Number | 1952791857
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Entity Type | Organization
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Legal Business Name | AMERICAN DENTAL CENTER OF NORTH BRUNSWICK, LLC
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 1950 ROUTE 27 SUITE E
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-1300
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Country | US
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Telephone | 732-821-0500
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Fax |
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Provider Business Mailing Address
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Address Line | 1950 ROUTE 27 SUITE E
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-1300
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Country | US
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Telephone | 732-821-0500
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. RICHARD ALAN KOSOFSKY
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Credential | D.M.D.
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Telephone | 732-821-0500
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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 | 22DI01084000
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License Number State | NJ
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