Provider Demographics
NPI:1407242167
Name:DENTAL CITY
Entity Type:Organization
Organization Name:DENTAL CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KESLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-387-0110
Mailing Address - Street 1:343 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-1935
Mailing Address - Country:US
Mailing Address - Phone:732-387-0110
Mailing Address - Fax:
Practice Address - Street 1:343 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:SAYREVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08872-1935
Practice Address - Country:US
Practice Address - Phone:732-387-0110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI020787001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty