Individual
DR. JUSTIN ELLIS DORNISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
741 TEANECK RD, TEANECK, NJ 07666-4261
(201) 837-9070
Mailing address
12 ELSINORE DR, HAINESPORT, NJ 08036-4800
(609) 694-0592
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02949000
NJ
Other
Enumeration date
04/02/2022
Last updated
09/11/2023
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