Individual
DR. GIANCARLO LUCIANO GHISALBERTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
7918 KENNEDY BLVD, NORTH BERGEN, NJ 07047-4120
(201) 854-1616
Mailing address
758 BERGEN BLVD, RIDGEFIELD, NJ 07657-1406
(201) 424-5599
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DR03255
NJ
1223G0001X
General Practice Dentistry
22DI02726900
NJ
Other
Enumeration date
06/28/2018
Last updated
07/10/2019
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