Healthcare Provider Details

I. General information

NPI: 1821721622
Provider Name (Legal Business Name): SNORE NO MORE BY ABS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2022
Last Update Date: 10/21/2022
Certification Date: 10/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 ANDERSON AVE STE A
FORT LEE NJ
07024-1732
US

IV. Provider business mailing address

1315 ANDERSON AVE STE A
FORT LEE NJ
07024-1732
US

V. Phone/Fax

Practice location:
  • Phone: 201-224-4400
  • Fax: 201-224-4418
Mailing address:
  • Phone: 855-859-3300
  • Fax: 201-224-4418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID JIN
Title or Position: OWNER/MBR-MGR
Credential: DDS
Phone: 201-224-4400