Provider Demographics
NPI:1326823832
Name:DENVILLE DENTAL STUDIO, LLC
Entity Type:Organization
Organization Name:DENVILLE DENTAL STUDIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTIMOVA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-328-7199
Mailing Address - Street 1:6 CHERYL LN
Mailing Address - Street 2:
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005-9005
Mailing Address - Country:US
Mailing Address - Phone:973-220-5021
Mailing Address - Fax:
Practice Address - Street 1:3125 STATE ROUTE 10 STE 1B
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-3431
Practice Address - Country:US
Practice Address - Phone:973-328-7199
Practice Address - Fax:973-328-7122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty