| Roselle Commons Dental Center, Pc | |
| 
					711 E 1st Ave Ste 5 Roselle NJ 07203-1669  | |
| (908) 259-0505 | |
| (908) 259-9885 | 
| Full Name | Roselle Commons Dental Center, Pc | 
|---|---|
| Speciality | Clinic/center - Dental | 
| Location | 711 E 1st Ave Ste 5, Roselle, New Jersey | 
| Authorized Official Name and Position | Simon Shalman (OFFICE MANAGER) | 
| Authorized Official Contact | 9082590505 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Roselle Commons Dental Center, Pc 711 E 1st Ave Ste 5 Roselle NJ 07203-1669 Ph: (908) 259-0505  | Roselle Commons Dental Center, Pc 711 E 1st Ave Ste 5 Roselle NJ 07203-1669 Ph: (908) 259-0505  | 
| NPI Number | 1396914396 | 
|---|---|
| Provider Enumeration Date | 02/22/2008 | 
| Last Update Date | 02/22/2008 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1396914396 | NPI | - | NPPES | 
| 7353103 | Medicaid | NJ | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 22DI02001800 (New Jersey) | Primary | 
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