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General NPI Number Information
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NPI Number | 1386997120
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Entity Type | Organization
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Legal Business Name | THE RIDGE DENTAL GROUP PC
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Dates
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Enumeration Date | 10/17/2012
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Last Update Date | 02/14/2018
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Provider Practice Location Address
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Address Line | 70 CHESTNUT RIDGE RD SUITE A AND B
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City | MONTVALE
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State | NJ
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Zip | 07645-1834
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Country | US
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Telephone | 201-391-1444
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Fax |
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Provider Business Mailing Address
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Address Line | 70 CHESTNUT RIDGE RD SUITE A AND B
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City | MONTVALE
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State | NJ
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Zip | 07645-1834
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Country | US
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Telephone | 201-391-1444
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Fax |
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Authorized Official
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Title or Position | DENTIST/PRESIDENT
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Name | DR. BARRY JOEL MORSE
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Credential | D.D.S
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Telephone | 201-391-1444
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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 | DIO18377
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License Number State | NJ
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