Provider Demographics
NPI:1366898462
Name:COMMUNITY DENTAL OF HAMILTON
Entity type:Organization
Organization Name:COMMUNITY DENTAL OF HAMILTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:PRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:609-879-6456
Mailing Address - Street 1:312 ROUTE 33
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619
Mailing Address - Country:US
Mailing Address - Phone:609-879-6456
Mailing Address - Fax:609-879-6486
Practice Address - Street 1:312 ROUTE 33
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619
Practice Address - Country:US
Practice Address - Phone:609-879-6456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0209111223G0001X
NJDI0204871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty