State Street Smiles
NPI #1073060612 in Hackensack, New Jersey
Provider Information
- NPI Number
- 1073060612
- Entity Type
- Organization
- Organization Name
- State Street Smiles
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- STATE STREET SMILES
- Primary Specialty
- Advanced Practice Dental Therapist
- Enumeration Date
- Sep 1, 2016
- Last Updated
- Sep 1, 2016
Practice Location
- Address
- 405 MAIN STREET
- City
- Hackensack
- State
- New Jersey
- ZIP Code
- 07601
- Phone
- (201) 487-7030
Authorized Official
- Name
- DR. EDWARD JACKSON
- Title
- DOCTOR
- Phone
- (201) 487-7030
Specialties & Taxonomy Codes
| Specialty |
|---|
| Advanced Practice Dental Therapist |
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