# 1137 FORT LEE LLC

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

## Provider details

- **NPI number:** 1780940395
- **Authorized official:** DR. JOSEPH MAURIELLO D.D.S. (DENTIST)
- **Authorized official phone:** (201) 224-8180

## Contact information

- **Practice address:** 1625 ANDERSON AVE, FORT LEE, NJ 07024-2748
- **Practice address phone:** (201) 944-1260
- **Mailing address:** 1625 ANDERSON AVE, FORT LEE, NJ 07024-2748
- **Mailing address phone:** (201) 944-1260

## Taxonomy

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

## Other

- **Enumeration date:** 04/09/2012
- **Last updated:** 04/09/2012