| Renaissance Dental Group, Pc | |
|
596 Anderson Ave Suite# 206a Cliffside Park NJ 07010 | |
| (201) 840-7777 | |
| (201) 840-0377 |
| Full Name | Renaissance Dental Group, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 596 Anderson Ave, Cliffside Park, New Jersey |
| Authorized Official Name and Position | Anita Shulman (PRESIDENT) |
| Authorized Official Contact | 2018407777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renaissance Dental Group, Pc 596 Anderson Ave Suite# 206a Cliffside Park NJ 07010 Ph: (201) 840-7777 | Renaissance Dental Group, Pc 596 Anderson Ave Suite# 206a Cliffside Park NJ 07010 Ph: (201) 840-7777 |
| NPI Number | 1073725248 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 05/08/2024 |
| Medicare PECOS PAC ID | 3577717495 |
|---|---|
| Medicare Enrollment ID | O20130131000070 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073725248 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Mikhail Shulman |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1346251675 PECOS PAC ID: 3173777091 Enrollment ID: I20130131000212 |
| Provider Name | Anita Shulman |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1134130461 PECOS PAC ID: 1355595273 Enrollment ID: I20130206000093 |
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