Provider Demographics
NPI:1689860025
Name:TAS, OZCAN JOHN (DMD)
Entity Type:Individual
Prefix:DR
First Name:OZCAN
Middle Name:JOHN
Last Name:TAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:476 BERGEN BLVD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:RIDGEFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07657-2818
Mailing Address - Country:US
Mailing Address - Phone:201-941-0131
Mailing Address - Fax:
Practice Address - Street 1:476 BERGEN BLVD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:RIDGEFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07657-2818
Practice Address - Country:US
Practice Address - Phone:201-941-0131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI-183371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice