Provider Demographics
NPI:1316070873
Name:PARKWAY 70 DENTAL CENTER, PA
Entity type:Organization
Organization Name:PARKWAY 70 DENTAL CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAN
Authorized Official - Middle Name:MORRIS
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-364-5656
Mailing Address - Street 1:1255 HIGHWAY 70
Mailing Address - Street 2:SUITE 10-S
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5900
Mailing Address - Country:US
Mailing Address - Phone:732-364-5656
Mailing Address - Fax:732-901-5149
Practice Address - Street 1:1255 HIGHWAY 70
Practice Address - Street 2:SUITE 10-S
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5900
Practice Address - Country:US
Practice Address - Phone:732-364-5656
Practice Address - Fax:732-901-5149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI153081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty