Organization
AGN DENTAL PRACTICES, PC
Active
Parent organization
AGN DENTAL PRACTICES, PC
Other names
NU Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
AGN DENTAL PRACTICES, PC
Authorized official
DR. ADMASU N GIZACHEW DDS (PRESIDENT/OWNER)
(347) 455-1108
Entity
Organization
Contact information
Practice address
178 HIGHWAY 35, EATONTOWN, NJ 07724-1883
(732) 475-7535
Mailing address
16 RIVERSIDE LN, HOLMDEL, NJ 07733-2084
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0440833
—
NJ
Enumeration date
12/04/2018
Last updated
12/04/2018
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