| Kinnelon Dental Group | |
|
11 Kiel Ave Kinnelon NJ 07405-2549 | |
| (973) 838-5585 | |
| (973) 838-6258 |
| Full Name | Kinnelon Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 11 Kiel Ave, Kinnelon, New Jersey |
| Authorized Official Name and Position | Jessica Lee Logan (EMPLOYEE) |
| Authorized Official Contact | 9738385585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kinnelon Dental Group 11 Kiel Ave Kinnelon NJ 07405-2549 Ph: (973) 838-5585 | Kinnelon Dental Group 11 Kiel Ave Kinnelon NJ 07405-2549 Ph: (973) 838-5585 |
| NPI Number | 1073671392 |
|---|---|
| Provider Enumeration Date | 12/06/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073671392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DI02262300 (New Jersey) | Primary |
Integrated Dental Aestetics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11 Kiel Ave, Kinnelon, NJ 07405 Phone: 973-838-4460 Fax: 973-838-6258 |