Individual
DR. JOHN THOMAS GENCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
362 RIDGEWAY ST, MOUNT HOLLY, NJ 08060-1447
(609) 267-3230
Mailing address
55 CHELSEA AVE APT 308, LONG BRANCH, NJ 07740-8165
(732) 557-1323
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22D102834000
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
NJ
Other
Enumeration date
05/13/2020
Last updated
08/12/2021
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