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General NPI Number Information
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NPI Number | 1588100267
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Entity Type | Organization
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Legal Business Name | ADVANCED DENTAL SOLUTIONS INC.
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Dates
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Enumeration Date | 01/18/2017
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 17 HANOVER RD STE 230
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-1409
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Country | US
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Telephone | 973-845-9955
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Fax |
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Provider Business Mailing Address
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Address Line | 17 HANOVER RD STE 230
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-1409
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Country | US
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Telephone | 973-845-9955
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Fax |
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Authorized Official
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Title or Position | OWNER/DDS
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Name | DR. ZEV SEGAL
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Credential |
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Telephone | 973-845-9955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 22DI01903100
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License Number State | NJ
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