Individual
MR. CHASE WHITLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 VILLAGE GREEN SHOPPING CTR STE 13, BUDD LAKE, NJ 07828-1706
(973) 347-8110
Mailing address
430 W 24TH ST APT 16E, NEW YORK, NY 10011-1349
(703) 674-6899
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02726700
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2016
Last updated
03/04/2020
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