| Excel Dentistry, P.c. | |
|
266 Harristown Rd Suite 102 Glen Rock NJ 07452-3302 | |
| (201) 652-0400 | |
| (201) 447-5762 |
| Full Name | Excel Dentistry, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 266 Harristown Rd, Glen Rock, New Jersey |
| Authorized Official Name and Position | Mayra Modesto-garrido (DENTIST) |
| Authorized Official Contact | 2016520400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Excel Dentistry, P.c. 266 Harristown Rd Suite 102 Glen Rock NJ 07452-3302 Ph: (201) 652-0400 | Excel Dentistry, P.c. 266 Harristown Rd Suite 102 Glen Rock NJ 07452-3302 Ph: (201) 652-0400 |
| NPI Number | 1982766853 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 02/12/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982766853 | NPI | - | NPPES |
| 6037704 | Medicaid | NJ | |
| 898217 | Other | NJ | UNITED CONCORDIA |
| 0066028 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 22DI01825501 (New Jersey) | Primary |
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