MEDICARE: CHOUDHARY GEETA DDS PC

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	122300000X	Dentist	22DI02159800	NJ

General Provider Information

NPI Number	:	1801218789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHOUDHARY GEETA DDS PC

Provider Business Mailing Address
First Line	:	422 PASCACK RD
Second Line	:	2ND FLOOR
City	:	TOWNSHIP OF WASHINGTON
State	:	NJ
Zip	:	07676-4837
Country	:	US
Telephone Number	:	201-497-3990
Fax Number	:	201-497-3992

Provider Business Practice Location Address
First Line	:	422 PASCACK RD
Second Line	:	2ND FLOOR
City	:	TOWNSHIP OF WASHINGTON
State	:	NJ
Zip	:	07676-4837
Country	:	US
Telephone Number	:	201-497-3990
Fax Number	:	201-497-3992

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GEETA CHOUDHARY
Credential	:	D.D.S.
Telephone Number	:	845-216-7737

Provider Enumeration Date	:	01/13/2014
Last Update Date	:	01/13/2014

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