| Liza Dental Management Inc. | |
|
1219 Liberty Ave Hillside NJ 07205-2055 | |
| (908) 352-2207 | |
| (908) 352-2208 |
| Full Name | Liza Dental Management Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1219 Liberty Ave, Hillside, New Jersey |
| Authorized Official Name and Position | Alexander Yermolenko (PRESIDENT) |
| Authorized Official Contact | 9083522207 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liza Dental Management Inc. 1219 Liberty Ave Hillside NJ 07205-2055 Ph: (908) 352-2207 | Liza Dental Management Inc. 1219 Liberty Ave Hillside NJ 07205-2055 Ph: (908) 352-2207 |
| NPI Number | 1356489116 |
|---|---|
| Provider Enumeration Date | 02/02/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356489116 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 19838 (New Jersey) | Primary |
Community Smiles Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1100 N Broad St, Hillside, NJ 07205 Phone: 908-409-7100 Fax: 908-409-5300 |