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General NPI Number Information
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NPI Number | 1023309234
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Entity Type | Organization
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Legal Business Name | DENTAL CARE ASSOCIATES OF HARRISON
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Dates
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Enumeration Date | 04/21/2011
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Last Update Date | 04/21/2011
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Provider Practice Location Address
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Address Line | 6 FRANK E RODGERS BLVD N
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City | HARRISON
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State | NJ
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Zip | 07029-1401
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Country | US
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Telephone | 973-484-3443
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Fax |
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Provider Business Mailing Address
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Address Line | 6 FRANK E RODGERS BLVD N
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City | HARRISON
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State | NJ
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Zip | 07029-1401
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Country | US
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Telephone | 973-484-3443
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. DAVID J GLICK
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Credential | D.M.D
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Telephone | 973-484-3443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DI 14706
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License Number State | NJ
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