Provider Demographics
NPI:1740298124
Name:PLAZA DENTAL HEALTH, PC
Entity type:Organization
Organization Name:PLAZA DENTAL HEALTH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUSNIYE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOGAN YESILYURT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-478-2221
Mailing Address - Street 1:1187 MAIN AVE
Mailing Address - Street 2:MAIN MALL PLAZA SUITE 1E
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2252
Mailing Address - Country:US
Mailing Address - Phone:973-478-2221
Mailing Address - Fax:973-478-5330
Practice Address - Street 1:1187 MAIN AVE
Practice Address - Street 2:MAIN MALL PLAZA SUITE 1E
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2252
Practice Address - Country:US
Practice Address - Phone:973-478-2221
Practice Address - Fax:973-478-5330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI212931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty