Organization
LAKESIDE ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN FERRARO (FINANCIAL COORDINATOR)
(973) 598-1600
Entity
Organization
Contact information
Practice address
22 STATE ROUTE 10 W, SUITE 102, SUCCASUNNA, NJ 07876-1731
(973) 598-1600
(973) 598-1618
Mailing address
22 ROUTE 10 WEST, SUITE 102, SUCCASUNNA, NJ 07876
(973) 598-1600
(973) 598-1618
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
22D101956300
NJ
Other
Enumeration date
04/11/2007
Last updated
08/22/2020
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