| Garden State Oral & Maxillofacial Surgery, Llc | |
|
1 Broadway Suite 101 Elmwood Park NJ 07407-1842 | |
| (201) 794-3344 | |
| (201) 794-0454 |
| Full Name | Garden State Oral & Maxillofacial Surgery, Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1 Broadway, Elmwood Park, New Jersey |
| Authorized Official Name and Position | Stuart Katz (PRESIDENT) |
| Authorized Official Contact | 2017943344 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Garden State Oral & Maxillofacial Surgery, Llc 1 Broadway Suite 101 Elmwood Park NJ 07407-1842 Ph: (201) 794-3344 | Garden State Oral & Maxillofacial Surgery, Llc 1 Broadway Suite 101 Elmwood Park NJ 07407-1842 Ph: (201) 794-3344 |
| NPI Number | 1104249226 |
|---|---|
| Provider Enumeration Date | 01/24/2014 |
| Last Update Date | 01/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104249226 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DI21870 (New Jersey) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DI15847 (New Jersey) | Primary |
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