| Portale Dental | |
|
555 Bergen Blvd Ridgefield NJ 07657-2020 | |
| (201) 945-5777 | |
| (201) 945-5667 |
| Full Name | Portale Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 555 Bergen Blvd, Ridgefield, New Jersey |
| Authorized Official Name and Position | Joseph John Portale (PRES/OWNER) |
| Authorized Official Contact | 2019455777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portale Dental 555 Bergen Blvd Ridgefield NJ 07657-2020 Ph: (201) 945-5777 | Portale Dental 555 Bergen Blvd Ridgefield NJ 07657-2020 Ph: (201) 945-5777 |
| NPI Number | 1952727182 |
|---|---|
| Provider Enumeration Date | 03/12/2014 |
| Last Update Date | 03/12/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952727182 | NPI | - | NPPES |
| 22DI00945900 | Other | NJ | LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 22DI00945900 (New Jersey) | Primary |
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