Provider Demographics
NPI:1871865691
Name:DOLIN, ELANA ROSE (DMD)
Entity type:Individual
Prefix:DR
First Name:ELANA
Middle Name:ROSE
Last Name:DOLIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1077 ROUTE 34 STE J
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2151
Mailing Address - Country:US
Mailing Address - Phone:732-441-3600
Mailing Address - Fax:
Practice Address - Street 1:1077 ROUTE 34 STE J
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NJ
Practice Address - Zip Code:07747-2151
Practice Address - Country:US
Practice Address - Phone:732-441-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI023873001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics