Provider Demographics
NPI:1508180936
Name:DA VINCI DENTAL ARTS, PA
Entity Type:Organization
Organization Name:DA VINCI DENTAL ARTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTIAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:MORAZAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MPH
Authorized Official - Phone:732-744-1188
Mailing Address - Street 1:102 JAMES ST
Mailing Address - Street 2:SUITE # 304
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3970
Mailing Address - Country:US
Mailing Address - Phone:732-744-1188
Mailing Address - Fax:732-744-1184
Practice Address - Street 1:102 JAMES ST
Practice Address - Street 2:SUITE # 304
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3970
Practice Address - Country:US
Practice Address - Phone:732-744-1188
Practice Address - Fax:732-744-1184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-14
Last Update Date:2010-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI020849001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty