| St Michael Dental Clinic Corporation | |
|
664 Broadway Bayonne NJ 07002-4726 | |
| (201) 823-2062 | |
| (201) 858-8696 |
| Full Name | St Michael Dental Clinic Corporation |
|---|---|
| Speciality | Dentist - Dental Public Health |
| Location | 664 Broadway, Bayonne, New Jersey |
| Authorized Official Name and Position | Olivia Yanni (PRESIDENT) |
| Authorized Official Contact | 2019939181 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Michael Dental Clinic Corporation 664 Broadway Bayonne NJ 07002-4726 Ph: (201) 823-2062 | St Michael Dental Clinic Corporation 664 Broadway Bayonne NJ 07002-4726 Ph: (201) 823-2062 |
| NPI Number | 1487996997 |
|---|---|
| Provider Enumeration Date | 03/22/2013 |
| Last Update Date | 03/22/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487996997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | 22DI02492200 (New Jersey) | Primary |
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