Individual
LAWRENCE SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
117 DELMAR AVE, GLEN ROCK, NJ 07452-3009
(201) 445-3930
Mailing address
117 DELMAR AVE, GLEN ROCK, NJ 07452-3009
(201) 445-3930
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22DI01065702
NJ
Other
Enumeration date
02/08/2007
Last updated
07/08/2007
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