Organization
BERGEN PASSAIC PERIODONTAL GROUP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERENCE JAY SMITH DDS (SECRETARY)
(201) 791-2200
Entity
Organization
Contact information
Practice address
25-15 FAIR LAWN AVE, FAIR LAWN, NJ 07410-3434
(201) 791-2200
(201) 791-6025
Mailing address
25-15 FAIR LAWN AVE, FAIR LAWN, NJ 07410-3434
(201) 791-2200
(201) 791-6025
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D11585
NJ
Other
Enumeration date
08/15/2006
Last updated
08/22/2020
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