Provider Demographics
NPI:1306945019
Name:CHECKETT, EDWARD H (DDS)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:H
Last Name:CHECKETT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 CEDARBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-4159
Mailing Address - Country:US
Mailing Address - Phone:732-920-1188
Mailing Address - Fax:732-920-9390
Practice Address - Street 1:990 CEDARBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4159
Practice Address - Country:US
Practice Address - Phone:732-920-1188
Practice Address - Fax:732-920-9390
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI200811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice