Individual
NICOLE PADOVAN-LAGRASTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, PA
Contact information
Practice address
105 E UNION AVE, BOUND BROOK, NJ 08805-1713
(732) 469-4424
(732) 469-9138
Mailing address
105 E UNION AVE, BOUND BROOK, NJ 08805-1713
(732) 469-4424
(732) 469-9138
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
020537
NJ
Other
Enumeration date
10/19/2006
Last updated
08/21/2012
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