| Glow Dental Spa P.c. | |
|
506 Hamburg Tpke Suite 101 Wayne NJ 07470-2068 | |
| (973) 942-6550 | |
| (973) 942-6553 |
| Full Name | Glow Dental Spa P.c. |
|---|---|
| Speciality | Dentist |
| Location | 506 Hamburg Tpke, Wayne, New Jersey |
| Authorized Official Name and Position | Behshad Ahkami (DOCTOR) |
| Authorized Official Contact | 9739426550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glow Dental Spa P.c. 506 Hamburg Tpke Suite 101 Wayne NJ 07470-2068 Ph: (973) 942-6550 | Glow Dental Spa P.c. 506 Hamburg Tpke Suite 101 Wayne NJ 07470-2068 Ph: (973) 942-6550 |
| NPI Number | 1033587381 |
|---|---|
| Provider Enumeration Date | 09/03/2015 |
| Last Update Date | 09/03/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033587381 | NPI | - | NPPES |
| 24362NJ | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DI020826 (New Jersey) | Primary |
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