# LTC MOBILE DENTAL SERVICES, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LTC MOBILE DENTAL SERVICES, P.A.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083936611
- **Authorized official:** DR. RAMA E. GVILDYS DMD (PRESIDENT)
- **Authorized official phone:** (551) 404-5769

## Contact information

- **Practice address:** 1961 MORRIS AVE, SUITE A-7, UNION, NJ 07083-3531
- **Practice address phone:** (551) 404-5769
- **Practice address fax:** (866) 810-8101
- **Mailing address:** 1961 MORRIS AVE, SUITE A-7, UNION, NJ 07083-3531
- **Mailing address phone:** (551) 404-5769
- **Mailing address fax:** (866) 810-8101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 22DI01820201 | NJ | Yes |
| 122300000X | Dentist | 22DI02289100 | NJ | — |

## Other

- **Enumeration date:** 02/23/2010
- **Last updated:** 09/01/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1285785006 | — | NJ |
| 05 | — | 1427108307 | — | NJ |
| 05 | — | 1700917127 | — | NJ |