# AGN DENTAL PRACTICES, PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AGN DENTAL PRACTICES, PC
- **Other names:** NU Dental
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1558831438
- **Legal business name:** AGN DENTAL PRACTICES, PC
- **Authorized official:** DR. ADMASU N GIZACHEW DDS (PRESIDENT/OWNER)
- **Authorized official phone:** (347) 455-1108

## Contact information

- **Practice address:** 178 HIGHWAY 35, EATONTOWN, NJ 07724-1883
- **Practice address phone:** (732) 475-7535
- **Mailing address:** 16 RIVERSIDE LN, HOLMDEL, NJ 07733-2084

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 12/04/2018
- **Last updated:** 12/04/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0440833 | — | NJ |