Willowbrook Mall Dental, Pa

LBN: Willowbrook Mall Dental, Pa
Willowbrook Mall Dental, Pa is an health care organization with primary practice located at 1445 Willowbrook Blvd , Wayne NJ 07470. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Willowbrook Mall Dental, Pa can be contacted via phone (973) 812-4426, or through Mikhailov, Alexander via phone (973) 812-4266.

Contact Information

Primary practice address
1445 Willowbrook Blvd Wayne NJ 07470
Phone: (973) 812-4426
Fax: (973) 812-4405
Website:
Map and Directions
Authorized official contact:
Name: Mikhailov, Alexander
Phone: (973) 812-4266

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 19779 New Jersey

Profile Details

NPI number 1174685713
LBN Legal business name Willowbrook Mall Dental, Pa
DBA Doing business as
Authorized official Mikhailov, Alexander
Entity Organization
Organization subpart 1 No
Enumeration date Dec 13th, 2006
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174685713 NPPES
New Jersey MEDICAID 8345201

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