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NPI Code Detail

MEDICARE: ADVANCED DENTAL CENTER P.A

MEDICARE: ADVANCED DENTAL CENTER P.A
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
11223G0001XGeneral Practice DentistryDI 19752NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DI 19752OTHERNJDENTAL LICENCE FOR DENTIS

General Provider Information

NPI Number : 1356556856
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED DENTAL CENTER P.A
Provider Business Mailing Address
First Line : 500 WESTFIELD AVE
Second Line :
City : ELIZABETH
State : NJ
Zip : 07208-1642
Country : US
Telephone Number : 908-354-4900
Fax Number :
Provider Business Practice Location Address
First Line : 500 WESTFIELD AVE
Second Line :
City : ELIZABETH
State : NJ
Zip : 07208-1642
Country : US
Telephone Number : 908-354-4900
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. RAJUBHAI M PATEL
Credential : D.D.S
Telephone Number : 908-354-4900
Provider Enumeration Date : 05/10/2007
Last Update Date : 08/22/2020

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Directions to “ADVANCED DENTAL CENTER P.A ” Practice Location

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