# EASTERN DENTAL OF LACEY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689722787
- **Authorized official:** DR. ANDREW DUBMAN D.M.D (DIRECTOR)
- **Authorized official phone:** (609) 693-6066

## Contact information

- **Practice address:** 131 S MAIN ST, FORKED RIVER, NJ 08731-3635
- **Practice address phone:** (609) 693-6066
- **Mailing address:** 1030 SAINT GEORGES AVE, AVENEL, NJ 07001-1390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 17953 | NJ | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 10967 | NJ | Yes |

## Other

- **Enumeration date:** 01/08/2007
- **Last updated:** 09/11/2025