| Jersey City Dental | |
|
162 Newark Ave Jersey City NJ 07302-2814 | |
| (201) 434-0919 | |
| (201) 434-1453 |
| Full Name | Jersey City Dental |
|---|---|
| Speciality | Dentist |
| Location | 162 Newark Ave, Jersey City, New Jersey |
| Authorized Official Name and Position | Sang Hoon Paek (MEMBER) |
| Authorized Official Contact | 9175836646 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jersey City Dental 162 Newark Ave Jersey City NJ 07302-2814 Ph: (201) 434-0919 | Jersey City Dental 162 Newark Ave Jersey City NJ 07302-2814 Ph: (201) 434-0919 |
| NPI Number | 1740593177 |
|---|---|
| Provider Enumeration Date | 07/14/2010 |
| Last Update Date | 07/14/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740593177 | NPI | - | NPPES |
| 0229296 | Medicaid | NJ | |
| 8983909 | Medicaid | NJ | |
| 0229288 | Medicaid | NJ | |
| 0218162 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2377100 (New Jersey) | Primary |
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