# BAYONNE FAMILY DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** North Bergen Dental Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376976506
- **Authorized official:** DR. PETER FUENTES DMD (OWNER)
- **Authorized official phone:** (201) 858-3800

## Contact information

- **Practice address:** 1216 KENNEDY BLVD, BAYONNE, NJ 07002-2208
- **Practice address phone:** (201) 858-3800
- **Mailing address:** 1216 KENNEDY BLVD, BAYONNE, NJ 07002-2208

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 22907 | NJ | Yes |

## Other

- **Enumeration date:** 08/12/2013
- **Last updated:** 08/12/2013