| The Clifton Center For Oral Surgery And Jaw Reconstruction Llc | |
|
905 Allwood Rd Suite 202 Clifton NJ 07012-1945 | |
| (973) 955-0100 | |
| (973) 955-0264 |
| Full Name | The Clifton Center For Oral Surgery And Jaw Reconstruction Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 905 Allwood Rd, Clifton, New Jersey |
| Authorized Official Name and Position | Pat Hernandez (OFFICE MANAGER) |
| Authorized Official Contact | 9739550100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Clifton Center For Oral Surgery And Jaw Reconstruction Llc 905 Allwood Rd Suite 202 Clifton NJ 07012-1945 Ph: (973) 955-0100 | The Clifton Center For Oral Surgery And Jaw Reconstruction Llc 905 Allwood Rd Suite 202 Clifton NJ 07012-1945 Ph: (973) 955-0100 |
| NPI Number | 1427281351 |
|---|---|
| Provider Enumeration Date | 08/26/2009 |
| Last Update Date | 08/26/2009 |
| Medicare PECOS PAC ID | 6507902889 |
|---|---|
| Medicare Enrollment ID | O20090930000626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427281351 | NPI | - | NPPES |
| 0203262 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 18029 (New Jersey) | Primary |
| Provider Name | Mendel I Markowitz |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1770646416 PECOS PAC ID: 8527104801 Enrollment ID: I20090930000606 |
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