Provider Demographics
NPI:1215367222
Name:NEW CITY DENTAL CARE PA
Entity Type:Organization
Organization Name:NEW CITY DENTAL CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:SOONHO
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-459-1800
Mailing Address - Street 1:3367 JOHN F KENNEDY BLVD # 1
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-4208
Mailing Address - Country:US
Mailing Address - Phone:201-459-1800
Mailing Address - Fax:201-459-1920
Practice Address - Street 1:3367 JOHN F KENNEDY BLVD # 1
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-4208
Practice Address - Country:US
Practice Address - Phone:201-459-1800
Practice Address - Fax:201-459-1920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02472400261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental