Provider Demographics
NPI:1346984689
Name:PABLO ACUNA DENTAL GROUP, LLC
Entity Type:Organization
Organization Name:PABLO ACUNA DENTAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:R
Authorized Official - Last Name:ACUNA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-600-2505
Mailing Address - Street 1:31 ELMBROOK PL
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3114
Mailing Address - Country:US
Mailing Address - Phone:973-600-2505
Mailing Address - Fax:
Practice Address - Street 1:180 WASHINGTON AVE FL 2
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-2541
Practice Address - Country:US
Practice Address - Phone:973-600-2505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-22
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental