Provider Demographics
NPI:1962818062
Name:GROWING FACES PEDIATRIC DENTISTRY
Entity type:Organization
Organization Name:GROWING FACES PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:D
Authorized Official - Last Name:HILLEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-720-2304
Mailing Address - Street 1:799 AMBOY AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3257
Mailing Address - Country:US
Mailing Address - Phone:732-375-1000
Mailing Address - Fax:732-375-1001
Practice Address - Street 1:799 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3257
Practice Address - Country:US
Practice Address - Phone:732-375-1000
Practice Address - Fax:732-375-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D102165600261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental