# RIDGEWOOD DENTISTRY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Glenn P Godart
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093922700
- **Authorized official:** GLENN P GODART DMD (OWNER)
- **Authorized official phone:** (201) 445-4808

## Contact information

- **Practice address:** 75 CHESTNUT ST, RIDGEWOOD, NJ 07450-2501
- **Practice address phone:** (201) 445-4808
- **Practice address fax:** (201) 445-9081
- **Mailing address:** 75 CHESTNUT ST, RIDGEWOOD, NJ 07450-2501
- **Mailing address phone:** (201) 445-4808
- **Mailing address fax:** (201) 445-9081

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 22DI01155300 | NJ | Yes |

## Other

- **Enumeration date:** 05/16/2007
- **Last updated:** 08/22/2020