Provider Demographics
NPI:1487711370
Name:ELSINGER, RICHARD W (DMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:W
Last Name:ELSINGER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 STATE ROUTE 35
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-2040
Mailing Address - Country:US
Mailing Address - Phone:732-671-3244
Mailing Address - Fax:732-671-8624
Practice Address - Street 1:1275 STATE ROUTE 35
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-2040
Practice Address - Country:US
Practice Address - Phone:732-671-3244
Practice Address - Fax:732-671-8624
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI015207001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice