Provider Demographics
NPI:1033268446
Name:SALVATORE J CARCARA DMD MS PC
Entity Type:Organization
Organization Name:SALVATORE J CARCARA DMD MS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SALVATORE
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CARCARA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MS
Authorized Official - Phone:201-664-4443
Mailing Address - Street 1:381 BROADWAY
Mailing Address - Street 2:SUITE 41
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675
Mailing Address - Country:US
Mailing Address - Phone:201-664-4443
Mailing Address - Fax:201-664-9101
Practice Address - Street 1:381 BROADWAY
Practice Address - Street 2:SUITE 41
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675
Practice Address - Country:US
Practice Address - Phone:201-664-4443
Practice Address - Fax:201-664-9101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI196011223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1010OtherDELTA DENTAL PIN #
NJ01527893OtherUNITED CONCORDIA PROVIDER
NJ19601OtherDELTA DENTAL PROVIDER #