Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Dental |
261QD0000X |
| NPI # | 1942906664 |
| LBN Legal business name | ADVANCED DENTAL GROUP NJ LLC |
| Authorized official | ALEXA BROWN - (MANAGING MEMBER/DENTIST) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 02/03/2023 |
| Last updated | 02/03/2023 - About 3 years ago |
| Identifiers | n/a |
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