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NPI Code Detail

MEDICARE: ERIN DENTAL LLC

MEDICARE: ERIN DENTAL 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
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1912644253
Entity Type Code : Organization
Provider Name (Legal Business Name) : ERIN DENTAL LLC
Provider Business Mailing Address
First Line : 235 CAPRI TER
Second Line :
City : PARK RIDGE
State : NJ
Zip : 07656-2411
Country : US
Telephone Number : 201-280-7691
Fax Number :
Provider Business Practice Location Address
First Line : 134 WASHINGTON AVE
Second Line :
City : LITTLE FERRY
State : NJ
Zip : 07643-2042
Country : US
Telephone Number : 201-280-7691
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. ERIN WELFEL PETERS
Credential : DMD
Telephone Number : 201-280-7691
Provider Enumeration Date : 05/18/2022
Last Update Date : 05/18/2022

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Directions to “ERIN DENTAL LLC ” Practice Location

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