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General NPI Number Information
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NPI Number | 1740068816
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Entity Type | Organization
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Legal Business Name | REFINE DENTAL CARE
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 09/19/2023
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Provider Practice Location Address
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Address Line | 521 LIVINGSTON ST STE 114
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City | NORWOOD
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State | NJ
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Zip | 07648-1358
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Country | US
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Telephone | 201-297-4443
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Fax |
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Provider Business Mailing Address
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Address Line | 31 GREENRIDGE AVE APT 2A
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City | WHITE PLAINS
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State | NY
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Zip | 10605-1214
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Country | US
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Telephone | 551-497-0464
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Fax |
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Authorized Official
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Title or Position | DENTIST / OWNER
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Name | DR. VANESSA GANG
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Credential |
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Telephone | 551-497-0464
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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 |
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License Number State |
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