Organization
SOUTH ORANGE DENTAL CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANIEL ROSEMOND DDS, FAGD (OWNER)
(973) 762-2660
Entity
Organization
Contact information
Practice address
481 S ORANGE AVE, SOUTH ORANGE, NJ 07079-2642
(973) 762-2660
(973) 762-5473
Mailing address
481 S ORANGE AVE, SOUTH ORANGE, NJ 07079-2642
(973) 762-2660
(973) 762-5473
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
11/26/2021
Last updated
11/26/2021
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