Organization
SHORE ENDODONTIC GROUP LLC
Active
Other names
Shore Endodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJEEV GUPTA D.D.S. (ENDODONTIST/OWNER)
(732) 349-9222
Entity
Organization
Contact information
Practice address
459 LAKEHURST RD, TOMS RIVER, NJ 08755-6342
(732) 349-9222
(732) 349-6213
Mailing address
459 LAKEHURST RD, TOMS RIVER, NJ 08755-6342
(732) 349-9222
(732) 349-6213
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
0600315348
NJ
Other
Enumeration date
08/21/2008
Last updated
08/21/2008
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