| Paterson Dental Clinic | |
|
294 Broadway Paterson NJ 07501-2030 | |
| (973) 684-5854 | |
| (973) 684-1952 |
| Full Name | Paterson Dental Clinic |
|---|---|
| Speciality | Dentist |
| Location | 294 Broadway, Paterson, New Jersey |
| Authorized Official Name and Position | Faizul T Khan (PRESIDENT) |
| Authorized Official Contact | 9736845854 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paterson Dental Clinic 294 Broadway Paterson NJ 07501-2030 Ph: (973) 684-5854 | Paterson Dental Clinic 294 Broadway Paterson NJ 07501-2030 Ph: (973) 684-5854 |
| NPI Number | 1235574872 |
|---|---|
| Provider Enumeration Date | 05/09/2013 |
| Last Update Date | 05/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235574872 | NPI | - | NPPES |
| 7093900-01 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DI19009 (New Jersey) | Primary |
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