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Organization

PALISDES PERIODONTICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PATRICIA MARRONE DDS (OWNER)
(201) 585-8282
Entity
Organization

Contact information

Practice address
1530 PALISADE AVE, FORT LEE, NJ 07024-5471
(201) 585-8282
Mailing address
1530 PALISADE AVE, FORT LEE, NJ 07024-5471
(201) 585-8282

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DI15888-01
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DI15888-01
DENTAL LICENSE
NJ
Enumeration date
05/01/2008
Last updated
05/01/2008
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