| Cory A. Wanatick,d.m.d.,p.a. | |
|
1563 Parker Ave Fort Lee NJ 07024-7002 | |
| (201) 461-4133 | |
| (201) 461-0796 |
| Full Name | Cory A. Wanatick,d.m.d.,p.a. |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1563 Parker Ave, Fort Lee, New Jersey |
| Authorized Official Name and Position | Cory A Wanatick (PRESIDENT) |
| Authorized Official Contact | 2014614133 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cory A. Wanatick,d.m.d.,p.a. 1563 Parker Ave Fort Lee NJ 07024-7002 Ph: (201) 461-4133 | Cory A. Wanatick,d.m.d.,p.a. 1563 Parker Ave Fort Lee NJ 07024-7002 Ph: (201) 461-4133 |
| NPI Number | 1508924754 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508924754 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | DI018012 (New Jersey) | Primary |
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