Organization
PEB DENTAL DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAYA RADAKRISHNA M.D. (PEDIATRICIAN)
(732) 752-1932
Entity
Organization
Contact information
Practice address
230 ROUTE 18, EAST BRUNSWICK, NJ 08816-1909
(732) 609-9106
(732) 752-1268
Mailing address
230 ROUTE 18, EAST BRUNSWICK, NJ 08816-1909
(732) 609-9106
(732) 752-1268
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0101028295
NJ
Other
Enumeration date
01/08/2015
Last updated
01/08/2015
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