| Bergenline Dental Group | |
|
1020 Main St Paterson NJ 07503-2244 | |
| (973) 225-9975 | |
| Not Available |
| Full Name | Bergenline Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 1020 Main St, Paterson, New Jersey |
| Authorized Official Name and Position | Peter Fuentes (OWNER) |
| Authorized Official Contact | 9732259975 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bergenline Dental Group 1020 Main St Paterson NJ 07503-2244 Ph: () - | Bergenline Dental Group 1020 Main St Paterson NJ 07503-2244 Ph: (973) 225-9975 |
| NPI Number | 1679919252 |
|---|---|
| Provider Enumeration Date | 05/22/2013 |
| Last Update Date | 05/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679919252 | NPI | - | NPPES |
| 0154831 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 22907 (New Jersey) | Primary |
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