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Provider Information for 1801900303



DR. ALLA PAVLUSHKIN DDS

Other Name:   THOMAS RAFTERTY
Gender: FEMALE

Individual NPI: 1801900303

Calendar Last Updated: 2007-07-08

Details

Name Value
NPI 1801900303
Enumeration Date 2006-08-19
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 2515 HWY 516 UNIT 2A
OLD BRIDGE, NJ 08857
United States

Phone: 732-607-0909 | Fax: 732-607-7555
View Map External Link
Primary Practice Address 2515 HWY 516 UNIT 2A EMPIRE DENTAL PC
OLD BRIDGE, NJ 08857
United States

Phone: 732-607-0909 | Fax: 732-607-7555
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice NJ DI19271
Other Identifiers
Issuer State Number