# PARAMUS DENTIST LLC

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

## Provider details

- **NPI number:** 1558067421
- **Authorized official:** DR. DAVID HANNA DMD (PROVIDER)
- **Authorized official phone:** (551) 200-1939

## Contact information

- **Practice address:** 122 E RIDGEWOOD AVE, PARAMUS, NJ 07652-4038
- **Practice address phone:** (201) 345-3898
- **Practice address fax:** (201) 345-3898
- **Mailing address:** 122 E RIDGEWOOD AVE, PARAMUS, NJ 07652-4038
- **Mailing address phone:** (201) 345-3898
- **Mailing address fax:** (201) 345-3898

## Taxonomy

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

## Other

- **Enumeration date:** 02/02/2023
- **Last updated:** 02/02/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 22DI02759600 | STATE LICENSE | NJ |