Provider Demographics
NPI:1528451168
Name:MILLBURN FAMILY DENTAL PA
Entity type:Organization
Organization Name:MILLBURN FAMILY DENTAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEEMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-661-8071
Mailing Address - Street 1:116 MILLBURN AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1943
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:116 MILLBURN AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1943
Practice Address - Country:US
Practice Address - Phone:516-661-8071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty