Organization
ST DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LANA MARYASH (OFFICE MGR)
(973) 479-3352
Entity
Organization
Contact information
Practice address
596 ANDERSON AVE, SUITE 305, CLIFFSIDE PARK, NJ 07010-1831
(973) 479-3352
Mailing address
596 ANDERSON AVE, SUITE 305, CLIFFSIDE PARK, NJ 07010-1831
(973) 479-3352
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02030400
NJ
Other
Enumeration date
07/30/2008
Last updated
07/30/2008
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