Provider Demographics
NPI:1205856671
Name:RT. 1 DENTAL, INC
Entity type:Organization
Organization Name:RT. 1 DENTAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAKHTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-940-0222
Mailing Address - Street 1:2229 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-4402
Mailing Address - Country:US
Mailing Address - Phone:732-940-0222
Mailing Address - Fax:732-940-5532
Practice Address - Street 1:2229 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-4402
Practice Address - Country:US
Practice Address - Phone:732-940-0222
Practice Address - Fax:732-940-5532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ200921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty