1137 Fort Lee LLC
NPI #1780940395 in Fort Lee, New Jersey
Provider Information
- NPI Number
- 1780940395
- Entity Type
- Organization
- Organization Name
- 1137 Fort Lee LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Apr 9, 2012
- Last Updated
- Apr 9, 2012
Practice Location
- Address
- 1625 ANDERSON AVE
- City
- Fort Lee
- State
- New Jersey
- ZIP Code
- 07024-2748
- Phone
- (201) 944-1260
Authorized Official
- Name
- DR. JOSEPH MAURIELLO, D.D.S.
- Title
- DENTIST
- Phone
- (201) 224-8180
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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