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General NPI Number Information
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NPI Number | 1982788501
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Entity Type | Organization
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Legal Business Name | NORTH JERSEY CENTER FOR ORAL & MAXILLOFACIAL SURGERY PA
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 01/24/2013
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Provider Practice Location Address
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Address Line | 315 CEDAR LN 2ND FL
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City | TEANECK
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State | NJ
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Zip | 07666-3442
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Country | US
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Telephone | 201-692-7737
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Fax | 201-287-9716
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Provider Business Mailing Address
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Address Line | 315 CEDAR LN 2ND FLOOR
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City | TEANECK
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State | NJ
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Zip | 07666-3442
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Country | US
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Telephone | 201-692-7737
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Fax | 201-287-9716
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Authorized Official
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Title or Position | OWNER
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Name | DR. JERALD S FRIEDMAN
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Credential | DDS
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Telephone | 201-692-7737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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