Organization
THE CLIFTON CENTER FOR ORAL SURGERY AND JAW RECONSTRUCTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAT HERNANDEZ (OFFICE MANAGER)
(973) 955-0100
Entity
Organization
Contact information
Practice address
905 ALLWOOD RD, SUITE 202, CLIFTON, NJ 07012-1945
(973) 955-0100
(973) 955-0264
Mailing address
905 ALLWOOD RD, SUITE 202, CLIFTON, NJ 07012-1945
(973) 955-0100
(973) 955-0264
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
18029
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0203262
—
NJ
Enumeration date
08/26/2009
Last updated
08/26/2009
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