Individual
KRISTEN NICOLE LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
168 NJ-10 WEST, SUCCASUNNA, NJ 07876
(973) 584-7555
Mailing address
21 LAKEVIEW AVE, PARK RIDGE, NJ 07656-1114
(845) 596-4557
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22DI02986600
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2021
Last updated
08/25/2023
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