Bergen Dental Practice, P.c.
NPI #1033378575 in Bergenfield, New Jersey
Provider Information
- NPI Number
- 1033378575
- Entity Type
- Organization
- Organization Name
- Bergen Dental Practice, P.c.
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jun 9, 2008
- Last Updated
- Jun 9, 2008
Practice Location
- Address
- 21 MAGNOLIA ST
- City
- Bergenfield
- State
- New Jersey
- ZIP Code
- 07621-3812
- Phone
- (201) 385-0013
Authorized Official
- Name
- DR. MOHAMMED MANSOORUL IMAM, DDS
- Title
- PRESIDENT
- Phone
- (201) 385-0013
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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