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Organization

BERGEN LINE ENDODONTICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VIKTORIA DEMIANENKO (OFFICE MANAGER)
(718) 373-6707
Entity
Organization

Contact information

Practice address
5918 BERGENLINE AVE, SUITE 201 B, WEST NEW YORK, NJ 07093-1392
(201) 861-2900
(201) 662-9662
Mailing address
5918 BERGENLINE AVE, SUITE 201 B, WEST NEW YORK, NJ 07093-1392
(201) 861-2900
(201) 662-9662

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary

Other

Enumeration date
10/30/2009
Last updated
10/30/2009
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