| The Smile Spa Of North Jersey,llc | |
|
251 Godwin Ave Midland Park NJ 07432-1882 | |
| (201) 445-2797 | |
| (201) 445-8340 |
| Full Name | The Smile Spa Of North Jersey,llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 251 Godwin Ave, Midland Park, New Jersey |
| Authorized Official Name and Position | Debra Rosenblatt (PROPRIETER) |
| Authorized Official Contact | 2014452797 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Smile Spa Of North Jersey,llc 251 Godwin Ave Midland Park NJ 07432-1882 Ph: (201) 445-2797 | The Smile Spa Of North Jersey,llc 251 Godwin Ave Midland Park NJ 07432-1882 Ph: (201) 445-2797 |
| NPI Number | 1710151089 |
|---|---|
| Provider Enumeration Date | 04/17/2008 |
| Last Update Date | 05/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710151089 | NPI | - | NPPES |
| 1301802 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 14180 (New Jersey) | Primary |
| 1223P0300X | Dentist - Periodontics | 2920508 (New Jersey) | Secondary |
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