Provider Demographics
NPI:1134284847
Name:A&E AESTHETIC DENTISTRY, LLC
Entity Type:Organization
Organization Name:A&E AESTHETIC DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEKSANDR
Authorized Official - Middle Name:
Authorized Official - Last Name:ROYZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-652-5524
Mailing Address - Street 1:124 W MIDLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1834
Mailing Address - Country:US
Mailing Address - Phone:201-652-5524
Mailing Address - Fax:
Practice Address - Street 1:124 W MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1834
Practice Address - Country:US
Practice Address - Phone:201-652-5524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ205291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty