Individual
LAWRENCE JEREMY GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
130 UNION AVE, MANASQUAN, NJ 08736-3636
(732) 528-7422
(732) 528-4765
Mailing address
130 UNION AVE, MANASQUAN, NJ 08736-3636
(732) 528-7422
(732) 528-4765
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI00910700
NJ
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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