Organization
HERAWATI T KANDOU DDS PA
Active
Parent organization
HERAWATI T KANDOU DDS PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
HERAWATI T KANDOU DDS PA
Authorized official
DR. HERAWATI T KANDOU DDS (PRESIDENT ORTHODONTIST)
(732) 560-5988
Entity
Organization
Contact information
Practice address
163 WASHINGTON VALLEY RD STE 106, WASHINGTON VALLEY OFFICE PARK, WARREN, NJ 07059-7181
(732) 560-5988
(732) 563-6999
Mailing address
163 WASHINGTON VALLEY RD STE 106, WASHINGTON VALLEY OFFICE PARK, WARREN, NJ 07059-7181
(732) 560-5988
(732) 563-6999
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9708
NJ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
3026
NJ
Other
Enumeration date
06/09/2008
Last updated
06/09/2008
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