Provider Demographics
NPI:1407371990
Name:VALDERRAMA AND HUSSAIN LLC
Entity Type:Organization
Organization Name:VALDERRAMA AND HUSSAIN LLC
Other - Org Name:DENTAL CARE OF SOUTH BRUNSWICK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:VALDERRAMA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-821-8585
Mailing Address - Street 1:3538 STATE ROUTE 27
Mailing Address - Street 2:
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824-1050
Mailing Address - Country:US
Mailing Address - Phone:732-821-8585
Mailing Address - Fax:
Practice Address - Street 1:3538 STATE ROUTE 27
Practice Address - Street 2:
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824-1050
Practice Address - Country:US
Practice Address - Phone:732-821-8585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02502200261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental