Basic Information
| Provider Information | |||||||||
| NPI: | 1861796070 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BHATT | ||||||||
| FirstName: | RUDRESH | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 59 KOCH AVE | ||||||||
| Address2: | GREYSTONE PARK HOSPITAL, DENTAL CLINIC | ||||||||
| City: | MORRIS PLAINS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07950 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9735381800 | ||||||||
| FaxNumber: | 9738898481 | ||||||||
| Practice Location | |||||||||
| Address1: | 59 KOCH AVE | ||||||||
| Address2: | GREYSTONE PARK HOSPITAL, DENTAL CLINIC | ||||||||
| City: | MORRIS PLAINS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07950 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9735381800 | ||||||||
| FaxNumber: | 9738898481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/03/2011 | ||||||||
| LastUpdateDate: | 01/03/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 22D102093600 | NJ | Y | Dental Providers | Dentist | General Practice |
No ID Information.