Organization
EASTERN DENTAL HOLDINGS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAN SCHWARZ DMD (OWNER)
(816) 953-5400
Entity
Organization
Contact information
Practice address
1030 ST. GEORGES AVENUE, SUITE 304, AVENEL, NJ 07001-1327
(732) 750-0707
(732) 750-5781
Mailing address
1030 ST. GEORGES AVENUE, SUITE 304, AVENEL, NJ 07001-1327
(732) 750-0707
(732) 750-5781
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
07/30/2020
Last updated
07/30/2020
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