Organization
CHILDREN'S DENTAL CENTER OF MONMOUTH, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE J. DIERNA D.D.S. (TREASURER)
(732) 671-1266
Entity
Organization
Contact information
Practice address
2 APPLE FARM RD, RED BANK, NJ 07701-5094
(732) 671-1266
(732) 671-2166
Mailing address
2 APPLE FARM RD, RED BANK, NJ 07701-5094
(732) 671-1266
(732) 671-2166
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
NJ
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0170186
—
NJ
Enumeration date
04/12/2006
Last updated
10/17/2011
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