Organization
PASSAIC DENTAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MONICA ROLLINS (OFFICE MANAGER)
(973) 778-7272
Entity
Organization
Contact information
Practice address
244 PAULISON AVE, PASSAIC, NJ 07055-3806
(973) 778-7272
(973) 778-5755
Mailing address
244 PAULISON AVE, PASSAIC, NJ 07055-3806
(973) 778-7272
(973) 778-5755
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02093500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0180041
—
NJ
Enumeration date
01/13/2009
Last updated
01/13/2009
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