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248 1st St Hackensack NJ 07601-3411 | |
| (201) 883-1886 | |
| (201) 883-1890 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 248 1st St, Hackensack, New Jersey |
| Authorized Official Name and Position | Judith Mamah (PRESIDENT) |
| Authorized Official Contact | 2018831886 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
248 1st St Hackensack NJ 07601-3411 Ph: (201) 883-1886 | 248 1st St Hackensack NJ 07601-3411 Ph: (201) 883-1886 |
| NPI Number | 1184784357 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184784357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DI20512 (New Jersey) | Primary |
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