| The Bedside Dentist Llc | |
|
1155 E Jersey St Elizabeth NJ 07201-2310 | |
| (609) 701-5100 | |
| Not Available |
| Full Name | The Bedside Dentist Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1155 E Jersey St, Elizabeth, New Jersey |
| Authorized Official Name and Position | Mark Lieberman (MANAGER) |
| Authorized Official Contact | 6097015100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Bedside Dentist Llc 1954 Kimball St Brooklyn NY 11234-4512 Ph: () - | The Bedside Dentist Llc 1155 E Jersey St Elizabeth NJ 07201-2310 Ph: (609) 701-5100 |
| NPI Number | 1316224215 |
|---|---|
| Provider Enumeration Date | 11/07/2011 |
| Last Update Date | 11/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316224215 | NPI | - | NPPES |
| 0275140 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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