| Dental Pm Pc | |
|
175 Market St 3rd Floor Paterson NJ 07505-1728 | |
| (201) 737-7283 | |
| Not Available |
| Full Name | Dental Pm Pc |
|---|---|
| Speciality | Dentist |
| Location | 175 Market St, Paterson, New Jersey |
| Authorized Official Name and Position | Rafael D Rodriguez (CEO) |
| Authorized Official Contact | 2017377283 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Pm Pc 4532 Kennedy Blvd Union City NJ 07087-2707 Ph: (201) 737-7283 | Dental Pm Pc 175 Market St 3rd Floor Paterson NJ 07505-1728 Ph: (201) 737-7283 |
| NPI Number | 1932570462 |
|---|---|
| Provider Enumeration Date | 10/09/2015 |
| Last Update Date | 07/20/2023 |
| Medicare PECOS PAC ID | 5395110803 |
|---|---|
| Medicare Enrollment ID | O20230417000164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932570462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 22DI02512900 (New Jersey) | Primary |
| Provider Name | Rafael Rodriguez |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1336351964 PECOS PAC ID: 4183865355 Enrollment ID: I20230417000148 |
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