Provider Demographics
NPI:1669045316
Name:RAHWAY DENTAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:RAHWAY DENTAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:R PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-798-4027
Mailing Address - Street 1:1361 SAINT GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:RAHWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07065-2760
Mailing Address - Country:US
Mailing Address - Phone:215-798-4027
Mailing Address - Fax:
Practice Address - Street 1:1361 SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:RAHWAY
Practice Address - State:NJ
Practice Address - Zip Code:07065-2760
Practice Address - Country:US
Practice Address - Phone:732-381-8968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental