Provider Demographics
NPI:1720590235
Name:GARDEN STATE DENTAL DESIGN INC
Entity Type:Organization
Organization Name:GARDEN STATE DENTAL DESIGN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:SZABELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-669-7227
Mailing Address - Street 1:727 RARITAN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-2241
Mailing Address - Country:US
Mailing Address - Phone:732-669-7227
Mailing Address - Fax:
Practice Address - Street 1:727 RARITAN RD
Practice Address - Street 2:SUITE 102
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-0706
Practice Address - Country:US
Practice Address - Phone:732-669-7227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental