Most Relevant Information
Provider Data
| NPI Number: | 1003027160 |
| Provider Name: | LAURIE ADDVENSKY D.M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | DIO17413 |
Most Important Dates
| Enumeration Date: | 05/24/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
79 W RIDGEWOOD AVE
RIDGEWOOD
NJ
074503142
Practice Location Phone/Fax
| Phone: | 2016520060 |
| Fax: | 2016527687 |
Provider Mailing Location
79 W RIDGEWOOD AVE
RIDGEWOOD
NJ
074503142
Provider Mailing Phone/Fax
| Phone: | 2016520060 |
| Fax: | 2016527687 |