# FAMILY DENTAL PRACTICE OF NEW JERSEY, LLC

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

## Provider details

- **NPI number:** 1952824310
- **Authorized official:** DR. RENE OSUALA DMD (OWNER)
- **Authorized official phone:** (908) 355-7800

## Contact information

- **Practice address:** 560 NEWARK AVE FL 2, ELIZABETH, NJ 07208-3307
- **Practice address phone:** (908) 355-7800
- **Practice address fax:** (908) 355-7800
- **Mailing address:** 560 NEWARK AVE FL 2, ELIZABETH, NJ 07208-3307
- **Mailing address phone:** (908) 355-7800
- **Mailing address fax:** (908) 355-7808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 22DI02524500 | NJ | Yes |

## Other

- **Enumeration date:** 07/18/2017
- **Last updated:** 07/18/2017