# AESTHETIC DENTAL CENTER OF HACKENSACK LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pangborn Dental Center LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154574804
- **Authorized official:** DARIA BAGAEVA (OFFICE MANAGER)
- **Authorized official phone:** (973) 361-6200

## Contact information

- **Practice address:** 161 MAIN ST, HACKENSACK, NJ 07601
- **Practice address phone:** (201) 488-8866
- **Practice address fax:** (201) 488-7663
- **Mailing address:** 163 MAIN ST STE A, HACKENSACK, NJ 07601-7124
- **Mailing address phone:** (201) 488-8866
- **Mailing address fax:** (201) 488-7663

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NJ | Yes |

## Other

- **Enumeration date:** 10/28/2008
- **Last updated:** 12/04/2019