Provider Demographics
NPI:1598831778
Name:DENTAL HEALTH ASSOCIATES PA
Entity Type:Organization
Organization Name:DENTAL HEALTH ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:G
Authorized Official - Last Name:LISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-387-6120
Mailing Address - Street 1:320 SOUTH MAIN STREET
Mailing Address - Street 2:CORPORATE OFFICE 2ND FLR
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865
Mailing Address - Country:US
Mailing Address - Phone:908-387-6120
Mailing Address - Fax:908-387-8322
Practice Address - Street 1:1146 STUYVESANT AVENUE
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111
Practice Address - Country:US
Practice Address - Phone:973-399-4242
Practice Address - Fax:973-399-4440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty