Individual
DR. OSTAP TERSHAKOVEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
340 E NORTHFIELD RD, SUITE 1C, LIVINGSTON, NJ 07039
(973) 994-7199
Mailing address
340 E NORTHFIELD RD, SUITE 1C, LIVINGSTON, NJ 07039
(973) 994-7199
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8496
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5066808
—
NJ
Enumeration date
10/16/2006
Last updated
07/08/2007
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