Provider Demographics
NPI:1598122905
Name:RINGWOOD FAMILY DENTAL LLC
Entity Type:Organization
Organization Name:RINGWOOD FAMILY DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HARSH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-962-4222
Mailing Address - Street 1:55 SKYLINE DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456-2037
Mailing Address - Country:US
Mailing Address - Phone:973-962-4222
Mailing Address - Fax:
Practice Address - Street 1:55 SKYLINE DR
Practice Address - Street 2:SUITE 210
Practice Address - City:RINGWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07456-2037
Practice Address - Country:US
Practice Address - Phone:973-962-4222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02468400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty