Organization
PRIME DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARSHNA MODY D.D.S (PRESIDENT)
(732) 225-2300
Entity
Organization
Contact information
Practice address
1036 AMBOY AVE, EDISON, NJ 08837-2806
(732) 225-2300
(732) 225-6336
Mailing address
1036 AMBOY AVE, EDISON, NJ 08837-2806
(732) 225-2300
(732) 225-6336
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI18045
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5386608
—
NJ
Enumeration date
02/14/2007
Last updated
08/22/2020
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