# GLENWOOD PREMIER DENTAL

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

## Provider details

- **NPI number:** 1598831190
- **Authorized official:** MR. MARK WASSEF (OWNER)
- **Authorized official phone:** (732) 264-4477

## Contact information

- **Practice address:** 1 BETHANY RD, BUILDING 1 SUITE 2 BETHANY OFFICE COMPLEX, HAZLET, NJ 07730
- **Practice address phone:** (732) 264-4477
- **Practice address fax:** (732) 264-0697
- **Mailing address:** 9 FREEMONT LANE, HOLMDEL, NJ 07733
- **Mailing address phone:** (732) 264-4477
- **Mailing address fax:** (732) 264-0697

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | D119435 | NJ | Yes |

## Other

- **Enumeration date:** 11/27/2006
- **Last updated:** 09/26/2013