Organization
PEB DENTAL DDS/PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAYA RADHAKRISHNA M.D. (PEDIATRICIAN)
(732) 752-1932
Entity
Organization
Contact information
Practice address
155 STELTON RD, PISCATAWAY, NJ 08854-3251
(732) 752-1932
(732) 752-1268
Mailing address
155 STELTON RD, PISCATAWAY, NJ 08854-3251
(732) 752-1932
(732) 752-1268
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0101028295
NJ
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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