Individual
DAVID PODOLNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3932 BLACK HORSE PIKE, MAYS LANDING, NJ 08330-3107
(609) 909-1100
(609) 909-9199
Mailing address
3932 BLACK HORSE PIKE, MAYS LANDING, NJ 08330-3107
(609) 909-1100
(609) 909-9199
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI01812000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0177
DELTA DENTAL PROVIDER ID
NJ
01
—
807715
UNITED CONCORDIA PROVIDER
PA
Enumeration date
10/10/2006
Last updated
07/08/2007
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