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Organization
LIZA DENTAL MANAGEMENT INC.
Active
Organization
LIZA DENTAL MANAGEMENT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDER YERMOLENKO D.D.S. (PRESIDENT)
(908) 352-2207
Entity
Organization
Contact information
Practice address
1219 LIBERTY AVE, HILLSIDE, NJ 07205-2055
(908) 352-2207
(908) 352-2208
Mailing address
1219 LIBERTY AVE, HILLSIDE, NJ 07205-2055
(908) 352-2207
(908) 352-2208
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
19838
NJ
Other
Enumeration date
02/02/2007
Last updated
08/22/2020
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