Organization
ECLADENT DENTAL STUDIO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA FAINVETS DMD (OWNER)
(917) 856-9529
Entity
Organization
Contact information
Practice address
139 SOUTH ST STE 104, NEW PROVIDENCE, NJ 07974-1999
(917) 856-9529
Mailing address
240 W WESTFIELD AVE APT 438, ROSELLE PARK, NJ 07204-2069
(917) 856-9529
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/13/2024
Last updated
07/13/2024
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