Organization
MILL ROAD DENTAL CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YEUGENY AUDEYCHIK DDS (DENTIST)
(973) 372-7049
Entity
Organization
Contact information
Practice address
5 MILL ROAD, IRVINGTON, NJ 07111
(973) 372-7049
(973) 372-7961
Mailing address
5 MILL ROAD, IRVINGTON, NJ 07111
(973) 372-7049
(973) 372-7961
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
19119
NJ
122300000X
Dentist
Primary
19161
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
636150101
—
NJ
Enumeration date
12/27/2006
Last updated
05/07/2013
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