| Family Dental Associates Of Brookdale, L.l.c. | |
|
988 Broad St Bloomfield NJ 07003-2806 | |
| (973) 338-6667 | |
| (973) 338-1856 |
| Full Name | Family Dental Associates Of Brookdale, L.l.c. |
|---|---|
| Speciality | Dentist |
| Location | 988 Broad St, Bloomfield, New Jersey |
| Authorized Official Name and Position | Michael S. Panitch (MEMBER-OWNER) |
| Authorized Official Contact | 9733386667 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dental Associates Of Brookdale, L.l.c. 988 Broad St Bloomfield NJ 07003-2806 Ph: (973) 338-6667 | Family Dental Associates Of Brookdale, L.l.c. 988 Broad St Bloomfield NJ 07003-2806 Ph: (973) 338-6667 |
| NPI Number | 1871644419 |
|---|---|
| Provider Enumeration Date | 01/12/2007 |
| Last Update Date | 06/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871644419 | NPI | - | NPPES |
| 21896 | Other | NJ | DENTAL LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 21896 (New Jersey) | Primary |
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