Organization
DNA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KEYANNA T INGRAU (OFFICE MANAGER)
(973) 535-4300
Entity
Organization
Contact information
Practice address
349 EAST NORTHFIELD RD, SUITE #207, LIVINGSTON, NJ 07039
(973) 535-4300
(973) 535-4308
Mailing address
349 E. NORTHFIELD RD, SUITE #207, LIVINGSTON, NJ 07039
(973) 535-4300
(973) 535-4308
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0300X
Periodontics
—
—
126800000X
Dental Assistant
Primary
22D101996200
NJ
Other
Enumeration date
12/08/2006
Last updated
07/02/2010
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