Provider Demographics
NPI:1639225360
Name:REIDENBERG, DAVID HAROLD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HAROLD
Last Name:REIDENBERG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 CLOVE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2138
Mailing Address - Country:US
Mailing Address - Phone:973-377-0877
Mailing Address - Fax:973-256-3300
Practice Address - Street 1:150 CLOVE RD
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-2138
Practice Address - Country:US
Practice Address - Phone:973-377-0877
Practice Address - Fax:973-256-3300
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ121361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice