21st Ave Dental Llc | |
318 21st Ave Paterson NJ 07501-3538 | |
(973) 742-1991 | |
Not Available |
Full Name | 21st Ave Dental Llc |
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Speciality | Dentist |
Location | 318 21st Ave, Paterson, New Jersey |
Authorized Official Name and Position | Patrick E Ryan (OWNER) |
Authorized Official Contact | 9737421991 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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21st Ave Dental Llc 318 21st Ave Paterson NJ 07501-3538 Ph: (973) 742-1991 | 21st Ave Dental Llc 318 21st Ave Paterson NJ 07501-3538 Ph: (973) 742-1991 |
NPI Number | 1114203387 |
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Provider Enumeration Date | 11/01/2011 |
Last Update Date | 11/01/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114203387 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 14409 (New Jersey) | Primary |
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