Organization
REJUVENATE DENTAL SLEEP MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYRA MODESTO-GARRIDO D.D.S. (DENTIST)
(201) 652-0400
Entity
Organization
Contact information
Practice address
266 HARRISTOWN RD, SUITE 102, GLEN ROCK, NJ 07452-3302
(201) 652-0400
(201) 447-5762
Mailing address
266 HARRISTOWN RD, SUITE 102, GLEN ROCK, NJ 07452-3302
(201) 652-0400
(201) 447-5762
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI01825500
NJ
Other
Enumeration date
05/31/2013
Last updated
06/27/2024
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