# BERGEN DENTAL GROUP

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

## Provider details

- **NPI number:** 1881097293
- **Authorized official:** DR. MONALI MA (PRESIDENT)
- **Authorized official phone:** (215) 485-8757

## Contact information

- **Practice address:** 7601 BROADWAY, NORTH BERGEN, NJ 07047-5723
- **Practice address phone:** (215) 485-8757
- **Mailing address:** 7601 BROADWAY, NORTH BERGEN, NJ 07047-5723
- **Mailing address phone:** (215) 485-8757

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 22DI02522600 | NJ | Yes |
| 1223P0300X | Periodontics | 22DI02521000 | NJ | — |

## Other

- **Enumeration date:** 09/30/2014
- **Last updated:** 10/02/2014