Convissar, Brad J

Convissar, Brad J is an individual health care provider with primary practice located at 2 Rancocas Blvd , Mount Laurel NJ 08054-2057. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Convissar, Brad J can be contacted via phone (856) 778-8655.

Contact Information

Primary practice address
2 Rancocas Blvd Mount Laurel NJ 08054-2057
Phone: (856) 778-8655
Fax: (856) 231-7480
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 22DI02233900 New Jersey

Profile Details

NPI number 1316009871
LBN Legal business name Convissar, Brad J
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2006
Last updated Dec 31st, 2021 - about 4 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.

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