| Grove Street Care Dental Inc. | |
|
129 Grove St Montclair NJ 07042-4049 | |
| (973) 746-0922 | |
| (973) 746-5230 |
| Full Name | Grove Street Care Dental Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 129 Grove St, Montclair, New Jersey |
| Authorized Official Name and Position | Samuel Lopez (PRESIDENT) |
| Authorized Official Contact | 9737460922 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grove Street Care Dental Inc. 129 Grove St Montclair NJ 07042-4049 Ph: (973) 746-0922 | Grove Street Care Dental Inc. 129 Grove St Montclair NJ 07042-4049 Ph: (973) 746-0922 |
| NPI Number | 1376719450 |
|---|---|
| Provider Enumeration Date | 05/07/2008 |
| Last Update Date | 05/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376719450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 18656 (New Jersey) | Primary |
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