| Bergen Dental Group | |
|
7601 Broadway North Bergen NJ 07047-5723 | |
| (215) 485-8757 | |
| Not Available |
| Full Name | Bergen Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 7601 Broadway, North Bergen, New Jersey |
| Authorized Official Name and Position | Monali Ma (PRESIDENT) |
| Authorized Official Contact | 2154858757 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bergen Dental Group 7601 Broadway North Bergen NJ 07047-5723 Ph: (215) 485-8757 | Bergen Dental Group 7601 Broadway North Bergen NJ 07047-5723 Ph: (215) 485-8757 |
| NPI Number | 1881097293 |
|---|---|
| Provider Enumeration Date | 09/30/2014 |
| Last Update Date | 10/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881097293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 22DI02522600 (New Jersey) | Primary |
| 1223P0300X | Dentist - Periodontics | 22DI02521000 (New Jersey) | Secondary |
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