| Victory 96 LLC | |
|
86 Valley Rd Ste 2 Montclair NJ 07042-2209 | |
| (973) 746-1616 | |
| Not Available |
| Full Name | Victory 96 LLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 86 Valley Rd Ste 2, Montclair, New Jersey |
| Authorized Official Name and Position | Thomas Rollo (OWNER) |
| Authorized Official Contact | 8625962898 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Victory 96 LLC 86 Valley Rd Ste 2 Montclair NJ 07042-2209 | Victory 96 LLC 86 Valley Rd Ste 2 Montclair NJ 07042-2209 Ph: (973) 746-1616 |
| NPI Number | 1487578480 |
|---|---|
| Provider Enumeration Date | 08/05/2026 |
| Last Update Date | 08/05/2026 |
| Certification Date | 08/05/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487578480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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