Organization
SOUTH AVENUE DENTAL GROUP
Active
Other names
South Avenue Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAJJA PATEL DMD (OWNER)
(203) 889-5379
Entity
Organization
Contact information
Practice address
104 SOUTH AVE E, CRANFORD, NJ 07016-2944
(203) 889-5379
Mailing address
1106 GRANDVIEW AVE, WESTFIELD, NJ 07090-1661
(646) 483-8824
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/30/2021
Last updated
06/30/2021
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