| Bergen Periodontic Assoc Llc | |
|
333 Old Hook Road Suite 104 Westwood NJ 07675 | |
| (201) 666-2330 | |
| (201) 666-5043 |
| Full Name | Bergen Periodontic Assoc Llc |
|---|---|
| Speciality | Dentist |
| Location | 333 Old Hook Road, Westwood, New Jersey |
| Authorized Official Name and Position | Liana Basceanu (OWNER) |
| Authorized Official Contact | 2016662330 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bergen Periodontic Assoc Llc 333 Old Hook Road Suite 104 Westwood NJ 07675 Ph: (201) 666-2330 | Bergen Periodontic Assoc Llc 333 Old Hook Road Suite 104 Westwood NJ 07675 Ph: (201) 666-2330 |
| NPI Number | 1972665875 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972665875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 22DIO842600 (New Jersey) | Primary |
| 122300000X | Dentist | (New Jersey) | Primary |
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