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Organization
NORTH BERGEN FAMILY DENTAL CARE LLC
Active
Organization
NORTH BERGEN FAMILY DENTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANORAMA GUNTUNUR DDS (GENERAL DENTIST)
(201) 869-0030
Entity
Organization
Contact information
Practice address
7821 BERGENLINE AVE, NORTH BERGEN, NJ 07047-4942
(201) 869-0030
(201) 869-0020
Mailing address
7821 BERGENLINE AVE, NORTH BERGEN, NJ 07047-4942
(201) 869-0030
(201) 869-0020
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI20520
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016386
AMERIGROUP
NJ
01
—
1086983
HORIZON HEALTH CARE
—
01
—
20520
DELTA
NJ
01
—
223354
CIGNA
—
01
—
30536
AETNA
NJ
05
—
7794509
—
NJ
01
—
985772
UNITED CONCORDIA
—
Enumeration date
12/06/2006
Last updated
08/22/2020
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