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General NPI Number Information
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NPI Number | 1619000288
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Entity Type | Organization
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Legal Business Name | TENAFLY DENTAL ASSOCIATES, PC
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2 DEAN DR
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City | TENAFLY
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State | NJ
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Zip | 07670-2765
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Country | US
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Telephone | 201-871-4505
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Fax |
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Provider Business Mailing Address
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Address Line | 2 DEAN DR
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City | TENAFLY
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State | NJ
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Zip | 07670-2765
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Country | US
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Telephone | 201-871-4505
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Fax |
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Authorized Official
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Title or Position | PRESIDET
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Name | DR. JOHN PATRICK HARTE
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Credential | D.M.D.
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Telephone | 201-871-4505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 22DI01135700
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License Number State | NJ
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