Provider Demographics
NPI:1558722785
Name:MICHAEL VANARIA, DMD, PC
Entity Type:Organization
Organization Name:MICHAEL VANARIA, DMD, PC
Other - Org Name:VANARIA DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VANARIA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:856-848-8400
Mailing Address - Street 1:159 DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-5914
Mailing Address - Country:US
Mailing Address - Phone:856-848-8400
Mailing Address - Fax:856-848-0885
Practice Address - Street 1:159 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-5914
Practice Address - Country:US
Practice Address - Phone:856-848-8400
Practice Address - Fax:856-848-0885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01518900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty