| Glenn P Godart | |
|
75 Chestnut St Ridgewood NJ 07450-2501 | |
| (201) 445-4808 | |
| (201) 445-9081 |
| Full Name | Glenn P Godart |
|---|---|
| Speciality | Dentist |
| Location | 75 Chestnut St, Ridgewood, New Jersey |
| Authorized Official Name and Position | Glenn P Godart (OWNER) |
| Authorized Official Contact | 2014454808 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glenn P Godart 75 Chestnut St Ridgewood NJ 07450-2501 Ph: (201) 445-4808 | Glenn P Godart 75 Chestnut St Ridgewood NJ 07450-2501 Ph: (201) 445-4808 |
| NPI Number | 1093922700 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093922700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 22DI01155300 (New Jersey) | Primary |
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