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General NPI Number Information
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NPI Number | 1962741769
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Entity Type | Individual
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Provider Name | ERIN KNOUSE DDS
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Gender | Female
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Dates
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Enumeration Date | 02/14/2013
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Last Update Date | 06/24/2024
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Provider Practice Location Address
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Address Line | 3458 NEELY RD 87 MEDICAL GROUP
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City | JB-MDL
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State | NJ
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Zip | 08641-5312
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Country | US
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Telephone | 609-754-3786
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Fax |
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Provider Business Mailing Address
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Address Line | 3458 NEELY RD 87 MEDICAL GROUP
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City | JB-MDL
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State | NJ
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Zip | 08641-5312
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Country | US
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Telephone | 609-754-3786
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 29231
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License Number State | TX
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