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Organization

ORTHODONTICS CENER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LISA FERMIN (PRACTICE MANAGER)
(551) 900-6200
Entity
Organization

Contact information

Practice address
79 HUDSON ST STE 201, HOBOKEN, NJ 07030-5640
(551) 900-6200
(551) 900-6205
Mailing address
79 HUDSON ST STE 201, HOBOKEN, NJ 07030-5640
(551) 900-6200
(551) 900-6205

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0662071
NJ
Enumeration date
03/12/2019
Last updated
06/11/2019
Update your record

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