Provider Demographics
NPI:1437921699
Name:DENVILLE DENTISTRY BY DESIGN LLC
Entity Type:Organization
Organization Name:DENVILLE DENTISTRY BY DESIGN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GILA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:845-641-8987
Mailing Address - Street 1:15 MARSHALL DR
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2910
Mailing Address - Country:US
Mailing Address - Phone:845-641-8987
Mailing Address - Fax:
Practice Address - Street 1:4 2ND AVE STE 206
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2748
Practice Address - Country:US
Practice Address - Phone:873-625-3335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty