Provider Demographics
NPI:1285056069
Name:PARSIPPANY PERIODONTAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:PARSIPPANY PERIODONTAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HARTNETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-586-6490
Mailing Address - Street 1:1280 ROUTE 46
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4911
Mailing Address - Country:US
Mailing Address - Phone:973-586-6490
Mailing Address - Fax:
Practice Address - Street 1:1280 ROUTE 46
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-4911
Practice Address - Country:US
Practice Address - Phone:973-586-6490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 017537261QD0000X
NJDI 23215261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental