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
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