Organization
DENTIUM DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RESHMA SHETTY DDS (DENTIST)
(732) 979-8008
Entity
Organization
Contact information
Practice address
965 AVENUE C, BAYONNE, NJ 07002-3019
(201) 339-3993
Mailing address
135 MONTGOMERY ST APT 16F, JERSEY CITY, NJ 07302-4628
(201) 339-3993
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0291323
—
NJ
Enumeration date
09/08/2018
Last updated
09/08/2018
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