| Om Dental Care Pc | |
|
480 Central Avenue Jersey City NJ 07307 | |
| (201) 222-0002 | |
| (201) 222-8211 |
| Full Name | Om Dental Care Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 480 Central Avenue, Jersey City, New Jersey |
| Authorized Official Name and Position | Hitesh J Shah (PRESIDENT) |
| Authorized Official Contact | 2012220002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Om Dental Care Pc 480 Central Avenue Jersey City NJ 07307 Ph: (201) 222-0002 | Om Dental Care Pc 480 Central Avenue Jersey City NJ 07307 Ph: (201) 222-0002 |
| NPI Number | 1790868701 |
|---|---|
| Provider Enumeration Date | 10/23/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790868701 | NPI | - | NPPES |
| G150101 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DI18862 (New Jersey) | Primary |
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