Provider Demographics
NPI:1689776601
Name:SPARTA DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:SPARTA DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:VAN ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-729-7200
Mailing Address - Street 1:3320 SPARTA AVENUE
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871
Mailing Address - Country:US
Mailing Address - Phone:973-729-7200
Mailing Address - Fax:973-729-8555
Practice Address - Street 1:3320 SPARTA AVENUE
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871
Practice Address - Country:US
Practice Address - Phone:973-729-7200
Practice Address - Fax:973-729-8555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty