Organization
DENTAL PROFESSIONALS OF FAIR LAWN PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JODY Z. BARDASH D.M.D. (DENTIST)
(201) 797-1555
Entity
Organization
Contact information
Practice address
10-06 SADDLE RIVER RD, FAIR LAWN, NJ 07410-5732
(201) 797-1555
(201) 797-1558
Mailing address
10-06 SADDLE RIVER RD, FAIR LAWN, NJ 07410-5732
(201) 797-1555
(201) 797-1558
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI00918500
NJ
1223G0001X
General Practice Dentistry
Primary
22DI01694700
NJ
1223G0001X
General Practice Dentistry
22DI02340000
NJ
Other
Enumeration date
09/08/2008
Last updated
04/28/2017
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