Healthcare Provider Details

I. General information

NPI: 1306285481
Provider Name (Legal Business Name): EAST HILL DENTAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2013
Last Update Date: 10/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 ENGLE ST SUITE 201
ENGLEWOOD NJ
07631-2535
US

IV. Provider business mailing address

163 ENGLE ST SUITE 201
ENGLEWOOD NJ
07631-2535
US

V. Phone/Fax

Practice location:
  • Phone: 201-568-2532
  • Fax: 201-568-3810
Mailing address:
  • Phone: 201-568-2532
  • Fax: 201-568-3810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number18204
License Number StateNJ

VIII. Authorized Official

Name: DR. FRANK JOHN GALTIERI
Title or Position: OWNER/PRESIDENT
Credential: DDS
Phone: 201-568-2532