# WORTZEL INTEGRATIVE DENTAL CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144625856
- **Authorized official:** DR. ROBERT A WORTZEL DMD (DENTIST)
- **Authorized official phone:** (908) 654-5151

## Contact information

- **Practice address:** 1122 ROUTE 22, MOUNTAINSIDE, NJ 07092-2812
- **Practice address phone:** (908) 654-5151
- **Practice address fax:** (908) 654-7791
- **Mailing address:** 1122 ROUTE 22, MOUNTAINSIDE, NJ 07092-2812
- **Mailing address phone:** (908) 654-5151
- **Mailing address fax:** (908) 654-7791

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 22D101187000 | NJ | Yes |
| 122300000X | Dentist | 22D102558000 | NJ | — |
| 122300000X | Dentist | 22D102559900 | NJ | — |

## Other

- **Enumeration date:** 10/24/2014
- **Last updated:** 10/24/2014