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General NPI Number Information
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NPI Number | 1427176049
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Entity Type | Individual
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Provider Name | CARMEN ROSA UCETA D.D.S
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5917 BERGENLINE AVE
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-1306
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Country | US
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Telephone | 201-861-2121
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Fax | 201-861-9820
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Provider Business Mailing Address
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Address Line | 316 LOCUST ST
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City | TEANECK
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State | NJ
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Zip | 07666-4004
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Country | US
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Telephone | 201-357-2014
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 22DI02046200
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License Number State | NJ
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