Organization
ENGLEWOOD DENTIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID HANNA DMD (OWNER)
(551) 200-1939
Entity
Organization
Contact information
Practice address
115 GRAND AVE, ENGLEWOOD, NJ 07631-3654
(201) 304-7077
(201) 304-7077
Mailing address
115 GRAND AVE, ENGLEWOOD, NJ 07631-3654
(201) 304-7077
(201) 304-7077
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22DI02759600
STATE LICENSE
NJ
Enumeration date
03/02/2023
Last updated
03/02/2023
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