Rick Dadouris

Individual provider Active NPI General Practice Dentistry · Clinton, NJ

NPI 1003944786 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1003944786
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DI15764 (NJ)
Practice address
12 Moebus PL
Clinton, NJ 08809-1023
Phone
(908) 730-6432
NPI assigned
Mar 2, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DI15764NJMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DI15764 NJ Yes

Addresses

Primary practice location

12 Moebus PL
Clinton, NJ 08809-1023

Mailing address

12 Moebus PL
Clinton, NJ 08809-1023

Other providers in Clinton, NJ

All providers in Clinton, NJ · General Practice Dentistry in New Jersey

Sources for this page

Verify at the official NPI Registry.