Organization
CLINTON HILL DENTAL ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEODORE DAVIS DDS (DENTIST)
(973) 374-5200
Entity
Organization
Contact information
Practice address
804 CINTON AVE, NEWARK, NJ 07108-1004
(973) 374-5200
(973) 374-5609
Mailing address
804 CINTON AVE, NEWARK, NJ 07108-1004
(973) 374-5200
(973) 374-5609
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2108128
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3414507
—
NJ
Enumeration date
03/13/2007
Last updated
08/22/2020
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