Individual
DR. BRIAN T DENICHILO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
136 KINDERKAMACK RD, SUITE 1, PARK RIDGE, NJ 07656-1370
(201) 930-9370
Mailing address
136 KINDERKAMACK RD, PARK RIDGE, NJ 07656-1370
(201) 930-9370
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D17859
NJ
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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