Individual
DR. KEVIN BRUCE PERSILY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
412 PLEASANT VALLEY WAY, WEST ORANGE, NJ 07052
(973) 731-2468
Mailing address
412 PLEASANT VALLEY WAY, WEST ORANGE, NJ 07052
(973) 731-2468
(973) 731-2501
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12019
NJ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
22DI01201900
NJ
Other
Enumeration date
02/07/2007
Last updated
09/26/2024
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