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General NPI Number Information
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NPI Number | 1295560829
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Entity Type | Organization
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Legal Business Name | GENUINE DENTAL MANAGEMENT LLC
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Dates
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Enumeration Date | 09/04/2024
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 2 W NORTHFIELD RD STE 302B
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City | LIVINGSTON
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State | NJ
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Zip | 07039-3758
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Country | US
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Telephone | 973-758-8922
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Fax | 551-219-5408
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Provider Business Mailing Address
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Address Line | 2 W NORTHFIELD RD STE 302B
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City | LIVINGSTON
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State | NJ
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Zip | 07039-3758
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Country | US
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Telephone | 973-758-8922
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Fax | 551-219-5408
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Authorized Official
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Title or Position | OWNER
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Name | MINA ELFAR
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Credential | DMD
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Telephone | 201-921-4667
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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 |
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License Number State |
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