# NICOLE PADOVAN-LAGRASTA DMD, PA

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

## Provider details

- **NPI number:** 1992982441
- **Authorized official:** DR. NICOLE PADOVAN-LAGRASTA DMD (PRESIDENT)
- **Authorized official phone:** (732) 469-4424

## Contact information

- **Practice address:** 105 E UNION AVE, BOUND BROOK, NJ 08805-1766
- **Practice address phone:** (732) 469-4424
- **Practice address fax:** (732) 469-9138
- **Mailing address:** 105 E UNION AVE, BOUND BROOK, NJ 08805-1766
- **Mailing address phone:** (732) 469-4424
- **Mailing address fax:** (732) 469-9138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |
| 124Q00000X | Dental Hygienist | — | — | — |
| 126800000X | Dental Assistant | — | — | — |

## Other

- **Enumeration date:** 01/28/2008
- **Last updated:** 01/28/2008