Organization
ROSELLE COMMONS DENTAL CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIMON SHALMAN (OFFICE MANAGER)
(908) 259-0505
Entity
Organization
Contact information
Practice address
711 E 1ST AVE STE 5, ROSELLE, NJ 07203-1669
(908) 259-0505
(908) 259-9885
Mailing address
711 E 1ST AVE STE 5, ROSELLE, NJ 07203-1669
(908) 259-0505
(908) 259-9885
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
22DI02001800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7353103
—
NJ
Enumeration date
02/22/2008
Last updated
02/22/2008
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