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Organization

REVOLUTIONARY BRIER HILL LLC

Active
Parent organization
REVOLUTIONARY DENTAL MANAGEMENT LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
REVOLUTIONARY DENTAL MANAGEMENT LLC
Authorized official
MR. FRANK FORTE (MANAGING MEMBER)
(732) 239-0565
Entity
Organization

Contact information

Practice address
E7 BRIER HILL CT, EAST BRUNSWICK, NJ 08816-3336
(732) 239-0565
Mailing address
1151 BROAD ST STE 216, SHREWSBURY, NJ 07702-4328
(732) 239-0565

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
02/14/2019
Last updated
02/14/2019
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