# LAKEWOOD DENTAL ASSOCIATES, LLC

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

## Provider details

- **NPI number:** 1760025894
- **Authorized official:** DOUGLAS GREENFIELD (COMPLIANCE OFFICER)
- **Authorized official phone:** (215) 422-3647

## Contact information

- **Practice address:** 838 RIVER AVE STE 1, LAKEWOOD, NJ 08701-5279
- **Practice address phone:** (732) 363-4477
- **Practice address fax:** (732) 905-7085
- **Mailing address:** 838 RIVER AVE STE 1, LAKEWOOD, NJ 08701-5279
- **Mailing address phone:** (732) 363-4477
- **Mailing address fax:** (732) 905-7085

## Taxonomy

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

## Other

- **Enumeration date:** 10/22/2019
- **Last updated:** 12/21/2019