Organization
DENTISTRY FOR CHILDREN, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA ANNE CLOONAN (OFFICE MANAGER)
(973) 338-1383
Entity
Organization
Contact information
Practice address
382 W PASSAIC AVE, BLOOMFIELD, NJ 07003-5552
(973) 338-1383
Mailing address
382 W PASSAIC AVE, BLOOMFIELD, NJ 07003-5552
(973) 338-1383
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
10726
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2597608
—
NJ
Enumeration date
07/26/2006
Last updated
08/22/2020
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