Provider Demographics
NPI:1821015645
Name:HUDSON COUNTY ORTHODONTICS LLC
Entity Type:Organization
Organization Name:HUDSON COUNTY ORTHODONTICS LLC
Other - Org Name:EAST RUTHERFORD ORTHODONTICS LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:MATTHIEW
Authorized Official - Last Name:MESSANA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-653-4474
Mailing Address - Street 1:42 LOCUST LANE
Mailing Address - Street 2:
Mailing Address - City:EAST RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07073
Mailing Address - Country:US
Mailing Address - Phone:201-653-4474
Mailing Address - Fax:201-623-2500
Practice Address - Street 1:42 LOCUST LANE
Practice Address - Street 2:
Practice Address - City:EAST RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07073
Practice Address - Country:US
Practice Address - Phone:201-653-4474
Practice Address - Fax:201-623-2500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01851400122300000X
NJDI0185141223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty