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General NPI Number Information
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NPI Number | 1417336074
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Entity Type | Organization
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Legal Business Name | GROVE FAMILY DENTAL INC
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Dates
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Enumeration Date | 05/28/2015
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 129 GROVE STREET
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City | MONTCLAIR
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State | NJ
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Zip | 07042
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Country | US
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Telephone | 973-509-0400
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Fax | 973-509-0477
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Provider Business Mailing Address
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Address Line | 129 GROVE STREET GROVE FAMILY DENTAL
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City | MONTCLAIR
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State | NJ
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Zip | 07042
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Country | US
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Telephone | 973-509-0400
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Fax | 973-509-0477
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RITU SETHI
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Credential | D.D.S
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Telephone | 973-509-0400
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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 |
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License Number State |
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