| Branford Dental Center | |
|
23 Branford Place Newark Nj NJ 07105 | |
| (973) 424-0040 | |
| (973) 424-0089 |
| Full Name | Branford Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 23 Branford Place, Newark Nj, New Jersey |
| Authorized Official Name and Position | Woo Il Steven Park (DENTIST) |
| Authorized Official Contact | 9734240040 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Branford Dental Center 23 Branford Place Newark Nj NJ 07105 Ph: (973) 424-0040 | Branford Dental Center 23 Branford Place Newark Nj NJ 07105 Ph: (973) 424-0040 |
| NPI Number | 1164781746 |
|---|---|
| Provider Enumeration Date | 05/16/2012 |
| Last Update Date | 05/16/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164781746 | NPI | - | NPPES |
| 0252727 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 22DI02324700 (New Jersey) | Primary |