Organization
ADVANCED DENTAL OF JERSEY CITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER DEMETRIUS TSAMBAZIS DMD (OWNER)
(973) 586-4444
Entity
Organization
Contact information
Practice address
223 MALLORY AVE, JERSEY CITY, NJ 07304-1256
(201) 232-3358
Mailing address
223 MALLORY AVE, JERSEY CITY, NJ 07304-1256
(201) 232-3358
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
18218
NJ
1223P0300X
Periodontics
Primary
18218
NJ
Other
Enumeration date
05/10/2011
Last updated
05/10/2011
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