Organization
FIRST-CLASS DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SERGEY MOLTON DDS (PRESIDENT)
(973) 479-3352
Entity
Organization
Contact information
Practice address
596 ANDERSON AVE, SUITE 305, CLIFFSIDE PARK, NJ 07010-1831
(973) 479-3352
(908) 636-2565
Mailing address
596 ANDERSON AVE, SUITE 305, CLIFFSIDE PARK, NJ 07010-1831
(973) 479-3352
(908) 636-2565
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
045359
NY
1223G0001X
General Practice Dentistry
22D102030400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045359
NY LICENCE #
NY
01
—
22D102030400
NJ
NJ
Enumeration date
10/20/2010
Last updated
08/18/2011
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