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Individual

DR. EVAN GUY WASSERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
301 MADISON AVE, LAKEWOOD, NJ 08701-3266
(732) 363-0177
(732) 363-0115
Mailing address
301 MADISON AVE, LAKEWOOD, NJ 08701-3266
(732) 363-0177
(732) 363-0115

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI01303200
NJ

Other

Enumeration date
07/19/2006
Last updated
07/08/2007
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