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Organization

VALLEY DENTAL ASSOCIATES, PA

Active
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Organization

VALLEY DENTAL ASSOCIATES, PA

Active
Other names
Portale Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH JOHN PORTALE DMD (PRES/OWNER)
(201) 945-5777
Entity
Organization

Contact information

Practice address
555 BERGEN BLVD, RIDGEFIELD, NJ 07657-2020
(201) 945-5777
(201) 945-5667
Mailing address
555 BERGEN BLVD, RIDGEFIELD, NJ 07657-2020
(201) 945-5777
(201) 945-5667

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
22DI00945900
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22DI00945900
LICENSE NUMBER
NJ
Enumeration date
03/12/2014
Last updated
03/12/2014
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