# DENTAL PLAZA PA

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

## Provider details

- **NPI number:** 1306049366
- **Authorized official:** DR. VINCE F DALESSIO DMD (PRESIDENT OF DENTAL PLAZA PA)
- **Authorized official phone:** (973) 471-4500

## Contact information

- **Practice address:** 503 PAULISON AVE, PASSAIC, NJ 07055
- **Practice address phone:** (973) 471-4500
- **Practice address fax:** (973) 471-4500
- **Mailing address:** 503 PAULISON AVE, PASSAIC, NJ 07055
- **Mailing address phone:** (973) 471-4500
- **Mailing address fax:** (973) 471-8575

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 018013 | NJ | — |
| 122300000X | Dentist | 16958 | NJ | Yes |
| 122300000X | Dentist | 17435 | NJ | — |

## Other

- **Enumeration date:** 06/07/2007
- **Last updated:** 08/22/2020