Organization
PASSAIC FAMILY DENTAL L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ESTELA D GUERRERO D.D.S. (OWNER)
(973) 815-0053
Entity
Organization
Contact information
Practice address
218 AUTUMN ST, 2 ND. FLOOR, PASSAIC, NJ 07055-4306
(973) 955-0512
(973) 815-0024
Mailing address
26 QUAKER AVE, PH, CORNWALL, NY 12518-2109
(973) 815-0053
(973) 815-0024
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0124001
—
NJ
Enumeration date
02/28/2008
Last updated
02/28/2008
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