| Bergenline Dental Group | |
|
3916 Bergenline Ave 2nd Floor Union City NJ 07087-1612 | |
| (201) 865-5150 | |
| (201) 865-5962 |
| Full Name | Bergenline Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3916 Bergenline Ave, Union City, New Jersey |
| Authorized Official Name and Position | Peter Fuentes (OWNER/PRESIDENT) |
| Authorized Official Contact | 2018655150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bergenline Dental Group 3916 Bergenline Ave 2nd Floor Union City NJ 07087-1612 Ph: (201) 865-5150 | Bergenline Dental Group 3916 Bergenline Ave 2nd Floor Union City NJ 07087-1612 Ph: (201) 865-5150 |
| NPI Number | 1043477565 |
|---|---|
| Provider Enumeration Date | 05/21/2008 |
| Last Update Date | 05/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043477565 | NPI | - | NPPES |
| 0154831 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 22907 (New Jersey) | Primary |
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