Provider Demographics
NPI:1760658751
Name:AESTHETIC DENTAL CARE, LLC
Entity type:Organization
Organization Name:AESTHETIC DENTAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-SOLE PROPRIETOR/ DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:STRAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-227-8998
Mailing Address - Street 1:287 RUTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2843
Mailing Address - Country:US
Mailing Address - Phone:973-227-8998
Mailing Address - Fax:201-837-7956
Practice Address - Street 1:389 PASSAIC AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-2017
Practice Address - Country:US
Practice Address - Phone:973-227-8998
Practice Address - Fax:201-837-7956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 0210401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty