Provider Demographics
NPI:1619987161
Name:LAURENCE LEFF DMD LLC
Entity Type:Organization
Organization Name:LAURENCE LEFF DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:CLIFFORD
Authorized Official - Last Name:LEFF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-753-3535
Mailing Address - Street 1:460 BLOOMFIELD AVE
Mailing Address - Street 2:SUITE 311
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3582
Mailing Address - Country:US
Mailing Address - Phone:973-783-3535
Mailing Address - Fax:973-783-4707
Practice Address - Street 1:460 BLOOMFIELD AVE
Practice Address - Street 2:SUITE 311
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3582
Practice Address - Country:US
Practice Address - Phone:973-783-3535
Practice Address - Fax:973-783-4707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI15317122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty