Organization
GERALD S. CONVISSAR DDS PA
Active
Other names
Rancocas Woods Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD S CONVISSAR DDS (PRESIDENT)
(856) 778-8655
Entity
Organization
Contact information
Practice address
2 RANCOCAS BLVD, MOUNT LAUREL, NJ 08054-2057
(856) 778-8655
(856) 231-7480
Mailing address
1373 HEARTWOOD DR, CHERRY HILL, NJ 08003-2741
(856) 778-8655
(856) 231-7480
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI01196800
NJ
Other
Enumeration date
12/14/2006
Last updated
08/22/2020
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