OrganizationActive
Bradley J Convissar DMD PA
NPI 1316607757 · Dental Clinic/Center · Mount Laurel, NJ
Provider details
- NPI number
- 1316607757
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Bradley Convissar, President(856) 778-8655
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
2 Rancocas Blvd
Mount Laurel, NJ 08054-2057
Phone: (856) 778-8655
Approximate (ZIP-level) locationGet directions
Mailing address
2 Rancocas Blvd
Mount Laurel, NJ 08054-2057
Registry dates
- Enumerated
- 2021-12-27
- Last updated
- 2021-12-27
- Certified
- 2021-12-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.