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NPI Code Detail

MEDICARE: ADVANCED DENTAL CENTER OF BERGEN, PC

MEDICARE: ADVANCED DENTAL CENTER OF BERGEN, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1396835179
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED DENTAL CENTER OF BERGEN, PC
Provider Business Mailing Address
First Line : 495 BOULEVARD
Second Line : SUITE 1
City : ELMWOOD PARK
State : NJ
Zip : 07407-2041
Country : US
Telephone Number : 201-300-6772
Fax Number : 201-773-4861
Provider Business Practice Location Address
First Line : 495 BOULEVARD
Second Line : SUITE 1
City : ELMWOOD PARK
State : NJ
Zip : 07407-2041
Country : US
Telephone Number : 201-300-6772
Fax Number : 201-773-4861
Authorized Official
Title or Position : GENERAL DENTIST
Name : DR. ROSALINA E HONG
Credential : D.D.S.
Telephone Number : 201-300-6772
Provider Enumeration Date : 10/13/2006
Last Update Date : 11/06/2015

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Directions to “ADVANCED DENTAL CENTER OF BERGEN, PC ” Practice Location

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