Individual
DR. LAURENCE DAVID SUSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
158 MAIN ST, MATAWAN, NJ 07747-4104
(732) 566-7648
(732) 566-1919
Mailing address
21 LIBERTY KNLS, COLTS NECK, NJ 07722-1363
(732) 741-3377
(732) 741-4955
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12856
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12856
NJ LICENCE NUMBER
NJ
Enumeration date
06/10/2006
Last updated
03/07/2023
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