# PARAMUS PARK MALL DENTAL LLC

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

## Provider details

- **NPI number:** 1164969325
- **Authorized official:** IGOR LEVIN DDS (DENTIST)
- **Authorized official phone:** (516) 798-3444

## Contact information

- **Practice address:** 700 PARAMUS PARK, SUITE 1615, PARAMUS, NJ 07652-3557
- **Practice address phone:** (201) 261-3444
- **Practice address fax:** (201) 261-3445
- **Mailing address:** 700 PARAMUS PARK, SUITE 1615, PARAMUS, NJ 07652-3557
- **Mailing address phone:** (201) 261-3444
- **Mailing address fax:** (201) 261-3445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 22DI 02242900 | NJ | Yes |

## Other

- **Enumeration date:** 01/26/2017
- **Last updated:** 01/26/2017