Provider Demographics
NPI:1194504464
Name:NOVO DENTAL LLC
Entity type:Organization
Organization Name:NOVO DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARBAGELATA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-878-6460
Mailing Address - Street 1:229 OUTWATER LN
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-2642
Mailing Address - Country:US
Mailing Address - Phone:973-772-2271
Mailing Address - Fax:
Practice Address - Street 1:229 OUTWATER LN
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-2642
Practice Address - Country:US
Practice Address - Phone:973-772-2271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty