Provider Demographics
NPI:1205956539
Name:ALLWOOD FAMILY DENTISTRY
Entity type:Organization
Organization Name:ALLWOOD FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAL
Authorized Official - Middle Name:S
Authorized Official - Last Name:WOLFSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-365-2265
Mailing Address - Street 1:46 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-2404
Mailing Address - Country:US
Mailing Address - Phone:973-365-2265
Mailing Address - Fax:973-458-8202
Practice Address - Street 1:46 MARKET ST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-2404
Practice Address - Country:US
Practice Address - Phone:973-365-2265
Practice Address - Fax:973-458-8202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1016023001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty