MEDICARE: ELIZABETH V ARCHER DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2200400	NJ

General Provider Information

NPI Number	:	1740393479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH V ARCHER DMD

Provider Business Mailing Address
First Line	:	838 BEAVER DAM RD
Second Line	:
City	:	POINT PLEASANT BORO
State	:	NJ
Zip	:	08742-3845
Country	:	US
Telephone Number	:	732-899-4420
Fax Number	:	732-899-4430

Provider Business Practice Location Address
First Line	:	838 BEAVER DAM RD
Second Line	:
City	:	POINT PLEASANT BORO
State	:	NJ
Zip	:	08742-3845
Country	:	US
Telephone Number	:	732-899-4420
Fax Number	:	732-899-4430

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	04/15/2019

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