Provider Demographics
NPI:1407933849
Name:FAMILY UNION DENTAL PRACTICE
Entity Type:Organization
Organization Name:FAMILY UNION DENTAL PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MILAGROS
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:GATON-MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-865-1353
Mailing Address - Street 1:2713 BERGENLINE AVE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-3706
Mailing Address - Country:US
Mailing Address - Phone:201-865-1353
Mailing Address - Fax:201-865-1556
Practice Address - Street 1:2713 BERGENLINE AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-3706
Practice Address - Country:US
Practice Address - Phone:201-865-1353
Practice Address - Fax:201-865-1556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty