Provider Demographics
NPI:1386997120
Name:THE RIDGE DENTAL GROUP PC
Entity type:Organization
Organization Name:THE RIDGE DENTAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-391-1444
Mailing Address - Street 1:70 CHESTNUT RIDGE RD
Mailing Address - Street 2:SUITE A AND B
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1834
Mailing Address - Country:US
Mailing Address - Phone:201-391-1444
Mailing Address - Fax:
Practice Address - Street 1:70 CHESTNUT RIDGE RD
Practice Address - Street 2:SUITE A AND B
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-1834
Practice Address - Country:US
Practice Address - Phone:201-391-1444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-17
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDIO18377122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty