Provider Demographics
NPI:1063556348
Name:DENTAL HEALTH CENTER OF HOLMDEL
Entity type:Organization
Organization Name:DENTAL HEALTH CENTER OF HOLMDEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRIDGES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-946-4244
Mailing Address - Street 1:146 STATE ROUTE 34
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-2407
Mailing Address - Country:US
Mailing Address - Phone:732-946-4244
Mailing Address - Fax:732-946-4492
Practice Address - Street 1:146 STATE ROUTE 34
Practice Address - Street 2:SUITE 200
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-2407
Practice Address - Country:US
Practice Address - Phone:732-946-4244
Practice Address - Fax:732-946-4492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1016168001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty