Provider Demographics
NPI:1285482745
Name:CTP DENTAL LLC
Entity type:Organization
Organization Name:CTP DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MIN
Authorized Official - Middle Name:HYCK
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:908-725-1933
Mailing Address - Street 1:575 ROUTE 28
Mailing Address - Street 2:BUILDING #3 SUITE 3100
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869
Mailing Address - Country:US
Mailing Address - Phone:908-725-1933
Mailing Address - Fax:
Practice Address - Street 1:575 ROUTE 28
Practice Address - Street 2:BUILDING #3 SUITE 3100
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869
Practice Address - Country:US
Practice Address - Phone:908-725-1933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty