State Street Smiles Pediatric Dentistry Llc.
NPI #1386883668 in Hackensack, New Jersey
Provider Information
- NPI Number
- 1386883668
- Entity Type
- Organization
- Organization Name
- State Street Smiles Pediatric Dentistry Llc.
- Primary Specialty
- Dentist - Pediatric Dentistry
- Enumeration Date
- Feb 11, 2009
- Last Updated
- Feb 11, 2009
Practice Location
- Address
- 405 STATE ST
- City
- Hackensack
- State
- New Jersey
- ZIP Code
- 07601-4421
- Phone
- (201) 487-7030
Authorized Official
- Name
- DR. EDWARD M JACKSON, DMD,FAAP
- Title
- PEDIATRIC DENTIST
- Phone
- (201) 487-7030
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Pediatric Dentistry — Pediatric Dentistry |
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