| Paramus Dentist LLC | |
|
122 E Ridgewood Ave Paramus NJ 07652-4038 | |
| (201) 345-3898 | |
| (201) 345-3898 |
| Full Name | Paramus Dentist LLC |
|---|---|
| Speciality | Dentist |
| Location | 122 E Ridgewood Ave, Paramus, New Jersey |
| Authorized Official Name and Position | David Hanna (PROVIDER) |
| Authorized Official Contact | 5512001939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paramus Dentist LLC 122 E Ridgewood Ave Paramus NJ 07652-4038 Ph: (201) 345-3898 | Paramus Dentist LLC 122 E Ridgewood Ave Paramus NJ 07652-4038 Ph: (201) 345-3898 |
| NPI Number | 1558067421 |
|---|---|
| Provider Enumeration Date | 02/02/2023 |
| Last Update Date | 02/02/2023 |
| Certification Date | 02/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558067421 | NPI | - | NPPES |
| 22DI02759600 | Other | NJ | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (NU) | Primary |
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