Provider Demographics
NPI:1700048311
Name:AC DENTAL OF UNION NJ, INC
Entity Type:Organization
Organization Name:AC DENTAL OF UNION NJ, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUNJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SETH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-254-9000
Mailing Address - Street 1:130 ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-3122
Mailing Address - Country:US
Mailing Address - Phone:973-379-9630
Mailing Address - Fax:973-379-9633
Practice Address - Street 1:130 ROUTE 22
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-3122
Practice Address - Country:US
Practice Address - Phone:973-379-9630
Practice Address - Fax:973-379-9633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02214900261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental