Elliot Morton Joseph Brooks, D.D.S.

Individual provider Active NPI General Practice Dentistry · Northfield, NJ

NPI 1336202084 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1336202084
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
22DI00685901 (NJ)
Practice address
1634 New Rd
Eastern Dental of Northfield
Northfield, NJ 08225-1108
Phone
(609) 677-1589
Fax
(609) 677-1593
NPI assigned
Dec 17, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
22DI00685901NJMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI00685901 NJ Yes

Addresses

Primary practice location

1634 New Rd
Eastern Dental of Northfield
Northfield, NJ 08225-1108

Mailing address

1 Evans Rd
Egg Harbor TWP, NJ 08234-5963
Phone (609) 653-2242

Other providers in Northfield, NJ

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

Sources for this page

Verify at the official NPI Registry.