Organization
ABA PEDIATRIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DMITRY SHTILMAN DDS (DENTIST)
(201) 386-0353
Entity
Organization
Contact information
Practice address
35 JOURNAL SQ STE 601, JERSEY CITY, NJ 07306-4011
(201) 386-0353
(201) 386-0356
Mailing address
35 JOURNAL SQ, SUITE 601, JERSEY CITY, NJ 07306-4011
(201) 386-0353
(201) 386-0356
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22DI01990900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7698704
—
NJ
Enumeration date
04/12/2007
Last updated
08/22/2020
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