Provider Demographics
NPI:1396962338
Name:NORTH HUNTERDON DENTAL ASSOC
Entity type:Organization
Organization Name:NORTH HUNTERDON DENTAL ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOCARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-730-8880
Mailing Address - Street 1:1630 STATE ROUTE 31
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809
Mailing Address - Country:US
Mailing Address - Phone:908-730-8880
Mailing Address - Fax:908-730-8407
Practice Address - Street 1:1630 STATE ROUTE 31
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-2004
Practice Address - Country:US
Practice Address - Phone:908-730-8880
Practice Address - Fax:908-730-8407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD1096131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1285785279OtherDENTAL OFFICE