| Organization Name: | DENTISTRY OF SOUTHBRUNSWICK |
| NPI Number: | 1275933236 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JILLENE DYE (OFFICE MANAGER) |
| Mailing Address: | 886 Georges Rd Monmouth Junction |
| State: | NJ US |
| Postal Code: | 088523028 |
| Phone Number: | 7329510099 |
| Fax Number: | 7329512323 |
| NPI Enumeration Date: | 08/27/2014 |
| NPI Last Update Date: | 11/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |