Provider Demographics
NPI:1508978974
Name:NORTHWOODS FAMILY DENTISTRY LLC
Entity Type:Organization
Organization Name:NORTHWOODS FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:MILONE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-767-7676
Mailing Address - Street 1:103 PARIS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07647-1515
Mailing Address - Country:US
Mailing Address - Phone:201-767-7676
Mailing Address - Fax:201-784-5356
Practice Address - Street 1:103 PARIS AVE
Practice Address - Street 2:
Practice Address - City:NORTHVALE
Practice Address - State:NJ
Practice Address - Zip Code:07647-1515
Practice Address - Country:US
Practice Address - Phone:201-767-7676
Practice Address - Fax:201-784-5356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ199531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty