Organization
RUTGERS SCHOOL OF DENTAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMARIE VACCARO (SR MGR BILLING & COLLECTIONS OFFICE)
(973) 972-4633
Entity
Organization
Contact information
Practice address
110 BERGEN ST, NEWARK, NJ 07103-2495
(973) 973-8668
Mailing address
110 BERGEN STREET, B842A, NEWARK, NJ 07103-2495
(973) 972-4242
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018309-01
—
NJ
Enumeration date
07/12/2007
Last updated
06/06/2024
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