Provider Demographics
NPI:1467688697
Name:ALL FAMILY DENTISTRY LLC
Entity Type:Organization
Organization Name:ALL FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:HELMUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-345-5550
Mailing Address - Street 1:669 BROADWAY APT 1
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514-1947
Mailing Address - Country:US
Mailing Address - Phone:973-345-5550
Mailing Address - Fax:973-333-8627
Practice Address - Street 1:669 BROADWAY APT 1
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1947
Practice Address - Country:US
Practice Address - Phone:973-345-5550
Practice Address - Fax:973-333-8627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI020699001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty