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Organization

NEW YORK AVENUE DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FADI I BEYDOUN D.M.D (PRESIDENT)
(201) 305-8800
Entity
Organization

Contact information

Practice address
3703 NEW YORK AVE, UNION CITY, NJ 07087-4807
(201) 305-8800
(201) 305-8900
Mailing address
3703 NEW YORK AVE, UNION CITY, NJ 07087-4807
(201) 305-8800
(201) 305-8900

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
261QD0000X
Dental Clinic/Center
19152
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0208540
NJ
Enumeration date
09/24/2009
Last updated
09/24/2009
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