Individual
DR. BALAJI SRINIVASAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1700 MADISON AVE, LAKEWOOD, NJ 08701-1253
(732) 363-5370
(732) 364-5684
Mailing address
26 BRENTWOOD DR, BAYVILLE, NJ 08721-2159
(732) 606-9194
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI19411
NJ
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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