Provider Demographics
NPI:1285278168
Name:DENTACARE, PC
Entity type:Organization
Organization Name:DENTACARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSSEINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-343-3232
Mailing Address - Street 1:810 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-4847
Mailing Address - Country:US
Mailing Address - Phone:201-343-3232
Mailing Address - Fax:201-343-1194
Practice Address - Street 1:810 MAIN ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-4847
Practice Address - Country:US
Practice Address - Phone:201-343-3232
Practice Address - Fax:201-343-1194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental