Provider Demographics
NPI:1154043669
Name:TEANECK FAMILY DENTAL LLC
Entity type:Organization
Organization Name:TEANECK FAMILY DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:G
Authorized Official - Last Name:ELDIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:609-547-3232
Mailing Address - Street 1:741 TEANECK RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4261
Mailing Address - Country:US
Mailing Address - Phone:609-547-3232
Mailing Address - Fax:609-594-1179
Practice Address - Street 1:741 TEANECK RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4261
Practice Address - Country:US
Practice Address - Phone:609-547-3232
Practice Address - Fax:609-594-1179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental