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Individual

KENNETH JAMES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
101 LUDLOW ST, NEWARK, NJ 07114-1108
(973) 565-0355
(973) 565-0461
Mailing address
1700 MYRTLE AVE, PLAINFIELD, NJ 07063-1000
(908) 753-6401

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22D102154500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1194996645
444 WILLIAM STREET
NJ
01
1740345693
741 BROADWAY
NJ
01
1972778413
1150 SPRINGFIELD AVE
NJ
05
8727309
NJ
Enumeration date
08/31/2006
Last updated
03/07/2023
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