Provider Demographics
NPI:1245457001
Name:TRAIN, VICTOR H (DDS)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:H
Last Name:TRAIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 STATE ROUTE 10
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2141
Mailing Address - Country:US
Mailing Address - Phone:973-361-6180
Mailing Address - Fax:973-361-6087
Practice Address - Street 1:390 STATE ROUTE 10
Practice Address - Street 2:SUITE 102
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-2141
Practice Address - Country:US
Practice Address - Phone:973-361-6180
Practice Address - Fax:973-361-6087
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ130891223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ13089OtherLICENSE
NJAT1228293OtherDEA#