Organization
CHESTNUT PLAZA DENTAL CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID M MAYER DMD (PRESIDENT)
(973) 405-5000
Entity
Organization
Contact information
Practice address
831 MAIN AVE, PASSAIC, NJ 07055-8400
(973) 405-5000
Mailing address
831 MAIN AVE, PASSAIC, NJ 07055-8400
(973) 405-5000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
22DI01365303
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0175536
—
NJ
Enumeration date
10/22/2008
Last updated
10/22/2008
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