MEDICARE: DR. RICHARD JAMES GENSLER DDS

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	DI13956	NJ

General Provider Information

NPI Number	:	1992848717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD JAMES GENSLER DDS

Provider Business Mailing Address
First Line	:	1303 MOUNT HOLLY RD
Second Line	:
City	:	BURLINGTON
State	:	NJ
Zip	:	08016-3733
Country	:	US
Telephone Number	:	609-386-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1303 MOUNT HOLLY RD
Second Line	:
City	:	BURLINGTON
State	:	NJ
Zip	:	08016-3733
Country	:	US
Telephone Number	:	609-386-5700
Fax Number	:

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

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	07/08/2007

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