Provider Demographics
NPI:1396835179
Name:ADVANCED DENTAL CENTER OF BERGEN, PC
Entity type:Organization
Organization Name:ADVANCED DENTAL CENTER OF BERGEN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSALINA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-300-6772
Mailing Address - Street 1:495 BOULEVARD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-2041
Mailing Address - Country:US
Mailing Address - Phone:201-300-6772
Mailing Address - Fax:201-773-4861
Practice Address - Street 1:495 BOULEVARD
Practice Address - Street 2:SUITE 1
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-2041
Practice Address - Country:US
Practice Address - Phone:201-300-6772
Practice Address - Fax:201-773-4861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty