Provider Demographics
NPI:1578001988
Name:THE DENTAL FAMILY JUNIOR
Entity Type:Organization
Organization Name:THE DENTAL FAMILY JUNIOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:FERRARA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-696-6002
Mailing Address - Street 1:531 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2107
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1130 RARITAN RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-3378
Practice Address - Country:US
Practice Address - Phone:908-232-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02487500261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental