Blumberg, Kenneth Mark
Blumberg, Kenneth Mark is an sole proprietor health care provider with primary practice located at 74 Rockledge Dr , Livingston NJ 07039-1124. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Blumberg, Kenneth Mark can be contacted via phone (973) 454-9009.Contact Information
Primary practice address
74 Rockledge Dr
Livingston NJ 07039-1124
Phone: (973) 454-9009
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Endodontics | 1223E0200X | 22DI00861600 | New Jersey |
Profile Details
| NPI number | 1619096401 |
|---|---|
| LBN Legal business name | Blumberg, Kenneth Mark |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 29th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619096401 | NPPES |
| New Jersey | Other | 8616 | DENTAL LICENSE |
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