Individual
DR. EDMUND RICHARD PROCTOR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
12 MOEBUS PLACE, CLINTON, NJ 08809-1023
(908) 713-6677
(908) 713-6120
Mailing address
129 MONMOUTH ROAD, ELIZABETH, NJ 07208
(908) 527-6368
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D1013938
NJ
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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