Individual
EDWARD DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
201 ROUTE 17, 12TH FLOOR, RUTHERFORD, NJ 07070-2574
(201) 549-8827
Mailing address
201 ROUTE 17, 12TH FLOOR, RUTHERFORD, NJ 07070-2574
(201) 549-8827
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02642300
NJ
Other
Enumeration date
06/21/2016
Last updated
06/21/2016
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