Glen Ridge Cosmetic and Family Dentistry

NPI #1083880819 in Glen Ridge, New Jersey

Provider Information

NPI Number: 1083880819
Entity Type: Organization
Organization Name: Glen Ridge Cosmetic and Family Dentistry
Primary Specialty: Dentist
Enumeration Date: May 1, 2008
Last Updated: May 1, 2008

Practice Location

Address: 89 GLEN RIDGE AVE
City: Glen Ridge
State: New Jersey
ZIP Code: 07028-1413
Phone: (973) 743-6092

Authorized Official

Name: LOUIS THEODOROU JR., DMD, FAGD
Title: OWNER
Phone: (973) 743-6092

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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