Healthcare Provider Details
I. General information
NPI: 1841310059
Provider Name (Legal Business Name): ENDODONTIC ASSOCIATES OF BERGEN COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
585 WINTERS AVE
PARAMUS NJ
07652-3901
US
IV. Provider business mailing address
585 WINTERS AVE
PARAMUS NJ
07652-3901
US
V. Phone/Fax
- Phone: 201-262-3636
- Fax: 201-262-6740
- Phone: 201-262-3636
- Fax: 201-262-6740
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
MICHAEL
FEINTUCH
Title or Position: OWNER
Credential: DMD
Phone: 201-262-3636