Provider Demographics
NPI:1184842999
Name:PROSTHODONTIC ASSOCIATES OF HOHOKUS
Entity Type:Organization
Organization Name:PROSTHODONTIC ASSOCIATES OF HOHOKUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ULLMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-444-0046
Mailing Address - Street 1:312 WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423-1581
Mailing Address - Country:US
Mailing Address - Phone:201-444-0046
Mailing Address - Fax:201-612-0423
Practice Address - Street 1:312 WARREN AVE
Practice Address - Street 2:
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1581
Practice Address - Country:US
Practice Address - Phone:201-444-0046
Practice Address - Fax:201-612-0423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ87201223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty