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General NPI Number Information
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NPI Number | 1932284288
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Entity Type | Organization
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Legal Business Name | DENTAL ARTS OF MAYWOOD, LLP
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 240 W PASSAIC ST
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City | MAYWOOD
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State | NJ
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Zip | 07607-1264
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Country | US
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Telephone | 201-843-4800
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Fax | 201-843-4773
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Provider Business Mailing Address
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Address Line | 240 W PASSAIC ST
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City | MAYWOOD
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State | NJ
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Zip | 07607-1264
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Country | US
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Telephone | 201-843-4800
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Fax | 201-843-4773
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. PAUL J KIM
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Credential | DDS
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Telephone | 201-843-4800
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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 | 1811002058
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License Number State | NY
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