Organization
NEW DENTAL IMAGE ASSO.CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODOLFO P WERT DDS (DENTIST)
(201) 295-1706
Entity
Organization
Contact information
Practice address
9238 KENNEDY BLVD, NORTH BERGEN, NJ 07047-5312
(201) 295-1706
(201) 295-9507
Mailing address
9238 KENNEDY BLVD, NORTH BERGEN, NJ 07047-5312
(201) 295-1706
(201) 295-9507
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0086185
—
NJ
Enumeration date
02/13/2007
Last updated
08/22/2020
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