DR. Louis John Theodorou JR., DMD, FAGD
NPI #1376614644 in Glen Ridge, New Jersey
Provider Information
- NPI Number
- 1376614644
- Entity Type
- Individual
- Name
- DR. Louis John Theodorou JR., DMD, FAGD
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - General Practice
- Credential
- DMD, FAGD
- Enumeration Date
- Nov 10, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 89 GLEN RIDGE AVE
- City
- Glen Ridge
- State
- New Jersey
- ZIP Code
- 07028-1413
- Phone
- (973) 743-6092
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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