# PEDIATRIC DENTISTRY AND ORTHODONTICS CENTER LLC

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

## Provider details

- **NPI number:** 1255995502
- **Authorized official:** VICTORIA JOHNSON (CRO)
- **Authorized official phone:** (941) 444-0558

## Contact information

- **Practice address:** 6 PROSPECT ST STE 1A, MIDLAND PARK, NJ 07432-1606
- **Practice address phone:** (201) 445-5555
- **Practice address fax:** (201) 445-5057
- **Mailing address:** 6 PROSPECT ST STE 1A, MIDLAND PARK, NJ 07432-1606
- **Mailing address phone:** (201) 445-5555

## Taxonomy

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

## Other

- **Enumeration date:** 04/23/2019
- **Last updated:** 07/21/2026