| 21st Ave Dental Llc | |
|
318 21st Ave Paterson NJ 07501-3538 | |
| (973) 742-1991 | |
| Not Available |
| Full Name | 21st Ave Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 318 21st Ave, Paterson, New Jersey |
| Authorized Official Name and Position | Patrick E Ryan (OWNER) |
| Authorized Official Contact | 9737421991 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 21st Ave Dental Llc 318 21st Ave Paterson NJ 07501-3538 Ph: (973) 742-1991 | 21st Ave Dental Llc 318 21st Ave Paterson NJ 07501-3538 Ph: (973) 742-1991 |
| NPI Number | 1114203387 |
|---|---|
| Provider Enumeration Date | 11/01/2011 |
| Last Update Date | 11/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114203387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 14409 (New Jersey) | Primary |
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