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Organization
STRONG ROOTS DENTAL PC
Active
Organization
STRONG ROOTS DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAHAYRA JUAREZ (OFFICE MANAGER)
(551) 200-6002
Entity
Organization
Contact information
Practice address
273 NEWARK AVENUE, JERSEY CITH, NJ 07302
(551) 200-6002
(201) 984-0607
Mailing address
273 NEWARK AVENUE, JERSEY CITH, NJ 07302
(551) 200-6002
(201) 984-0607
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02410701
NJ
1223G0001X
General Practice Dentistry
22DIO2449200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0257761
—
NJ
Enumeration date
01/31/2012
Last updated
02/28/2019
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