Dr Mayra Modesto-garrido, DDS | |
266 Harristown Rd, Suite 102, Glen Rock, NJ 07452-3302 | |
(201) 652-0400 | |
(201) 447-5762 |
Full Name | Dr Mayra Modesto-garrido |
---|---|
Gender | Female |
Speciality | Dentist - General Practice |
Location | 266 Harristown Rd, Glen Rock, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568524528 | NPI | - | NPPES |
0066028 | Medicaid | NJ | |
6037704 | Medicaid | NJ | |
898217 | Other | NJ | UNITED CONCORDIA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 22DI01825501 (New Jersey) | Primary |
Entity Name | Rejuvenate Dental Sleep Medicine |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1851738736 PECOS PAC ID: 9537486899 Enrollment ID: O20150325001038 |
Mailing Address | Practice Location Address |
---|---|
Dr Mayra Modesto-garrido, DDS 266 Harristown Rd, Suite 102, Glen Rock, NJ 07452-3302 Ph: (201) 652-0400 | Dr Mayra Modesto-garrido, DDS 266 Harristown Rd, Suite 102, Glen Rock, NJ 07452-3302 Ph: (201) 652-0400 |
Russell Zaat, D.D.S Dentist Medicare: Medicare Enrolled Practice Location: 39 Wellesley Rd, Glen Rock, NJ 07452 Phone: 201-670-0097 Fax: 201-445-0225 | |
Teresa Michaud, DDS Dentist Medicare: Medicare Enrolled Practice Location: 849 Lincoln Ave, Glen Rock, NJ 07452 Phone: 201-445-1166 Fax: 201-445-3337 | |
Dr. Tamar Gruenbaum, D.D.S Dentist Medicare: Not Enrolled in Medicare Practice Location: 385 S Maple Ave, Suite 107, Glen Rock, NJ 07452 Phone: 201-652-2707 | |
Dr. David Glenn Schoenberg, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 39 Wellesley Rd, Glen Rock, NJ 07452 Phone: 201-670-0097 Fax: 201-445-0225 | |
Dr. Bruce Walter Bitzer, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 385 S Maple Ave, Glen Rock, NJ 07452 Phone: 201-201-6520 Fax: 201-652-0004 | |
Rinat Roth, DDS Dentist Medicare: Medicare Enrolled Practice Location: 39 Wellesley Rd, Glen Rock, NJ 07452 Phone: 201-670-0097 Fax: 201-445-0225 | |
Dr. Jacquelyn Ann Dawson, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 237 Rock Rd, Glen Rock, NJ 07452 Phone: 201-612-8066 Fax: 201-612-1478 |