MEDICARE: BEAUTY DENTAL CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1073327086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEAUTY DENTAL CARE LLC

Provider Business Mailing Address
First Line	:	3607 PARK AVE UNIT C
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-6031
Country	:	US
Telephone Number	:	201-430-4054
Fax Number	:	201-430-5043

Provider Business Practice Location Address
First Line	:	3607 PARK AVE UNIT C
Second Line	:
City	:	UNION CITY
State	:	NJ
Zip	:	07087-6031
Country	:	US
Telephone Number	:	201-430-4054
Fax Number	:	201-430-5043

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. MARINA ISAAC
Credential	:	DMD
Telephone Number	:	201-430-4054

Provider Enumeration Date	:	02/03/2025
Last Update Date	:	02/03/2025

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