Provider Demographics
NPI:1922855717
Name:DR ROW DDS LLC
Entity type:Organization
Organization Name:DR ROW DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNGMIN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:ROW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-342-0704
Mailing Address - Street 1:71 UNION AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-1272
Mailing Address - Country:US
Mailing Address - Phone:201-460-0820
Mailing Address - Fax:
Practice Address - Street 1:71 UNION AVE STE 203
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-1272
Practice Address - Country:US
Practice Address - Phone:201-460-0820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty