# AESTHESTIC & IMPLANT DENTAL ASSOCIATES PROFESSIONAL CORPORATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1710606488
- **Authorized official:** JESSICA DESKINS (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (724) 466-2644

## Contact information

- **Practice address:** 155 N DEAN ST STE B, ENGLEWOOD, NJ 07631-2532
- **Practice address phone:** (201) 568-6465
- **Mailing address:** 155 N DEAN ST, ENGLEWOOD, NJ 07631-2532

## Taxonomy

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

## Other

- **Enumeration date:** 08/25/2022
- **Last updated:** 08/25/2022