| Chestnut Plaza Dental Center Pa | |
|
831 Main Ave Passaic NJ 07055-8400 | |
| (973) 405-5000 | |
| Not Available |
| Full Name | Chestnut Plaza Dental Center Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 831 Main Ave, Passaic, New Jersey |
| Authorized Official Name and Position | David M Mayer (PRESIDENT) |
| Authorized Official Contact | 9734055000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chestnut Plaza Dental Center Pa 831 Main Ave Passaic NJ 07055-8400 Ph: (973) 405-5000 | Chestnut Plaza Dental Center Pa 831 Main Ave Passaic NJ 07055-8400 Ph: (973) 405-5000 |
| NPI Number | 1447402359 |
|---|---|
| Provider Enumeration Date | 10/22/2008 |
| Last Update Date | 10/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447402359 | NPI | - | NPPES |
| 0175536 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 22DI01365303 (New Jersey) | Primary |
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