| Modern Dental | |
|
422 Main St Fl 1 Fort Lee NJ 07024-2861 | |
| (201) 585-1838 | |
| (201) 585-1719 |
| Full Name | Modern Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 422 Main St Fl 1, Fort Lee, New Jersey |
| Authorized Official Name and Position | Hyun Won Anna Shin (DENTIST) |
| Authorized Official Contact | 2015851838 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Dental 422 Main St Fl 1 Fort Lee NJ 07024-2861 Ph: (201) 585-1838 | Modern Dental 422 Main St Fl 1 Fort Lee NJ 07024-2861 Ph: (201) 585-1838 |
| NPI Number | 1467971614 |
|---|---|
| Provider Enumeration Date | 09/19/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467971614 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 22DI0226700 (New Jersey) | Primary |
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