Organization
GD NJ RANDOLPH LLC
Active
Other names
Smith Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD HENDRICKS (CREDENTIALING)
(612) 859-0444
Entity
Organization
Contact information
Practice address
2 W HANOVER AVE STE 201, RANDOLPH, NJ 07869-4222
(973) 895-5111
Mailing address
2 W HANOVER AVE STE 201, RANDOLPH, NJ 07869-4222
(973) 895-5111
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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