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General NPI Number Information
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NPI Number | 1003180142
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Entity Type | Organization
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Legal Business Name | BERGEN DENTAL AND SPECIALTIES LLC
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 50 ESSEX ST
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-4341
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Country | US
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Telephone | 201-343-8888
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Fax | 201-845-4341
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Provider Business Mailing Address
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Address Line | 50 ESSEX ST
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City | ROCHELLE PARK
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State | NJ
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Zip | 07662-4341
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Country | US
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Telephone | 201-343-8888
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Fax | 201-845-4341
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JASON F SCHEPIS
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Credential | D.M.D
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Telephone | 201-343-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DIO2318500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DIO2319300
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License Number State | NJ
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