Healthcare Provider Details

I. General information

NPI: 1902928971
Provider Name (Legal Business Name): VILLAGE DENTAL,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 MAIN ST
RIDGEFIELD PARK NJ
07660-1598
US

IV. Provider business mailing address

255 MAIN ST
RIDGEFIELD PARK NJ
07660-1598
US

V. Phone/Fax

Practice location:
  • Phone: 201-440-9190
  • Fax: 201-440-1288
Mailing address:
  • Phone: 201-440-9190
  • Fax: 201-440-1288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number018175
License Number StateNJ

VIII. Authorized Official

Name: DR. KATHLEEN ARZINGER
Title or Position: OWNER
Credential: D.M.D
Phone: 201-440-9190