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Organization
BERGEN DENTAL GROUP
Active
Organization
BERGEN DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONALI MA (PRESIDENT)
(215) 485-8757
Entity
Organization
Contact information
Practice address
7601 BROADWAY, NORTH BERGEN, NJ 07047-5723
(215) 485-8757
Mailing address
7601 BROADWAY, NORTH BERGEN, NJ 07047-5723
(215) 485-8757
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02522600
NJ
1223P0300X
Periodontics
22DI02521000
NJ
Other
Enumeration date
09/30/2014
Last updated
10/02/2014
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