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Organization
SOUTH AVENUE DENTAL GROUP
Active
Organization
SOUTH AVENUE DENTAL GROUP
Active
Other names
South Avenue Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAJJA PATEL DMD (OWNER)
(203) 889-5379
Entity
Organization
Contact information
Practice address
104 SOUTH AVE E, CRANFORD, NJ 07016-2944
(203) 889-5379
Mailing address
1106 GRANDVIEW AVE, WESTFIELD, NJ 07090-1661
(646) 483-8824
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/30/2021
Last updated
06/30/2021
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