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General NPI Number Information
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NPI Number | 1952797003
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Entity Type | Organization
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Legal Business Name | GENTLE FAMILY DENTISTRY NJ L.L.C.
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Dates
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Enumeration Date | 04/15/2015
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 220 N WASHINGTON AVE
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City | DUNELLEN
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State | NJ
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Zip | 08812-1246
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Country | US
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Telephone | 732-624-9500
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Fax | 732-624-9502
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Provider Business Mailing Address
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Address Line | 220 N WASHINGTON AVE
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City | DUNELLEN
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State | NJ
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Zip | 08812-1246
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Country | US
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Telephone | 732-624-9500
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Fax | 732-624-9502
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. SAIMA MIAN
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Credential | D.M.D.
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Telephone | 732-624-9500
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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 | 21485
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License Number State | NJ
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