Organization
CORY A. WANATICK,D.M.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORY A WANATICK D.M.D. (PRESIDENT)
(201) 461-4133
Entity
Organization
Contact information
Practice address
1563 PARKER AVE, FORT LEE, NJ 07024-7002
(201) 461-4133
(201) 461-0796
Mailing address
1563 PARKER AVE, FORT LEE, NJ 07024-7002
(201) 461-4133
(201) 461-0796
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DI018012
NJ
Other
Enumeration date
12/04/2006
Last updated
08/22/2020
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