Organization
NICOLE PADOVAN-LAGRASTA DMD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE PADOVAN-LAGRASTA DMD (PRESIDENT)
(732) 469-4424
Entity
Organization
Contact information
Practice address
105 E UNION AVE, BOUND BROOK, NJ 08805-1766
(732) 469-4424
(732) 469-9138
Mailing address
105 E UNION AVE, BOUND BROOK, NJ 08805-1766
(732) 469-4424
(732) 469-9138
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
01/28/2008
Last updated
01/28/2008
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