Provider Demographics
NPI:1366185142
Name:CLINTON CENTER DENTAL NJ
Entity type:Organization
Organization Name:CLINTON CENTER DENTAL NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MILAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-730-7565
Mailing Address - Street 1:3 ARBOR CT
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-2045
Mailing Address - Country:US
Mailing Address - Phone:908-337-1320
Mailing Address - Fax:
Practice Address - Street 1:1465 ROUTE 31 S STE 29
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:NJ
Practice Address - Zip Code:08801-3131
Practice Address - Country:US
Practice Address - Phone:908-730-7565
Practice Address - Fax:908-730-7965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty