Organization
JONATHAN DENTAL SPA AT THE CENTER FOR COSMETIC & IMPLANT DENTISTRY LLC
Active
Other names
Jonathan Dental Spa
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN ABENAIM DMD (OWNER)
(973) 423-4460
Entity
Organization
Contact information
Practice address
1111 GOFFLE RD, HAWTHORNE, NJ 07506-2025
(973) 423-4460
Mailing address
1111 GOFFLE RD, HAWTHORNE, NJ 07506-2025
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
02/15/2022
Last updated
02/15/2022
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