Healthcare Provider Details

I. General information

NPI: 1306815097
Provider Name (Legal Business Name): ALLEN A SCHACHTER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 KINDERKAMACK RD SUITE 304
RIVER EDGE NJ
07661-1939
US

IV. Provider business mailing address

648 N FOREST DR
TEANECK NJ
07666-2047
US

V. Phone/Fax

Practice location:
  • Phone: 201-489-7444
  • Fax:
Mailing address:
  • Phone: 201-836-8597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number08581
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: