# PATERSON DENTAL CLINIC

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

## Provider details

- **NPI number:** 1235574872
- **Authorized official:** DR. FAIZUL T KHAN DDS (PRESIDENT)
- **Authorized official phone:** (973) 684-5854

## Contact information

- **Practice address:** 294 BROADWAY, PATERSON, NJ 07501-2030
- **Practice address phone:** (973) 684-5854
- **Practice address fax:** (973) 684-1952
- **Mailing address:** 294 BROADWAY, PATERSON, NJ 07501-2030
- **Mailing address phone:** (973) 684-5854

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DI19009 | NJ | Yes |

## Other

- **Enumeration date:** 05/09/2013
- **Last updated:** 05/09/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7093900-01 | — | NJ |