Individual
DR. LOUIS JOHN THEODOROU JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, FAGD
Contact information
Practice address
89 GLEN RIDGE AVE, GLEN RIDGE, NJ 07028-1413
(973) 743-6092
Mailing address
89 GLEN RIDGE AVE, GLEN RIDGE, NJ 07028-1413
(973) 743-6092
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NJ
Other
Enumeration date
11/10/2006
Last updated
07/08/2007
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