| Advanced Dental Of Jersey City Llc | |
|
223 Mallory Ave Jersey City NJ 07304-1256 | |
| (201) 232-3358 | |
| Not Available |
| Full Name | Advanced Dental Of Jersey City Llc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 223 Mallory Ave, Jersey City, New Jersey |
| Authorized Official Name and Position | Peter Demetrius Tsambazis (OWNER) |
| Authorized Official Contact | 9735864444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Dental Of Jersey City Llc 223 Mallory Ave Jersey City NJ 07304-1256 Ph: (201) 232-3358 | Advanced Dental Of Jersey City Llc 223 Mallory Ave Jersey City NJ 07304-1256 Ph: (201) 232-3358 |
| NPI Number | 1003108051 |
|---|---|
| Provider Enumeration Date | 05/10/2011 |
| Last Update Date | 05/10/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003108051 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 18218 (New Jersey) | Secondary |
| 1223P0300X | Dentist - Periodontics | 18218 (New Jersey) | Primary |
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