Organization
GROVE STREET CARE DENTAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL LOPEZ D.M.D. (PRESIDENT)
(973) 746-0922
Entity
Organization
Contact information
Practice address
129 GROVE ST, MONTCLAIR, NJ 07042-4049
(973) 746-0922
(973) 746-5230
Mailing address
129 GROVE ST, MONTCLAIR, NJ 07042-4049
(973) 746-0922
(973) 746-5230
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18656
NJ
Other
Enumeration date
05/07/2008
Last updated
05/07/2008
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