Healthcare Provider Details

I. General information

NPI: 1366810343
Provider Name (Legal Business Name): UNION FAMILY DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2015
Last Update Date: 11/18/2022
Certification Date: 11/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 MORRIS AVE STE A111
UNION NJ
07083-5737
US

IV. Provider business mailing address

2333 MORRIS AVE STE A111
UNION NJ
07083-5737
US

V. Phone/Fax

Practice location:
  • Phone: 86-877-0369
  • Fax: 908-687-5215
Mailing address:
  • Phone: 908-687-7036
  • Fax: 908-687-5215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL HENRY HOGAN
Title or Position: OWNER
Credential: DDS
Phone: 908-687-7036