Provider Demographics
NPI:1700357597
Name:TEANECK DENTIST LLC
Entity Type:Organization
Organization Name:TEANECK DENTIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARI
Authorized Official - Middle Name:
Authorized Official - Last Name:FROHLICH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-837-3000
Mailing Address - Street 1:1008 TEANECK RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4516
Mailing Address - Country:US
Mailing Address - Phone:201-837-3000
Mailing Address - Fax:201-837-0997
Practice Address - Street 1:1008 TEANECK RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4516
Practice Address - Country:US
Practice Address - Phone:201-837-3000
Practice Address - Fax:201-837-0997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-06
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty