Provider Demographics
NPI:1801992136
Name:UPPER MONTCLAIR DENTAL ASSOCIATES
Entity type:Organization
Organization Name:UPPER MONTCLAIR DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:PRESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-746-6506
Mailing Address - Street 1:223 LORRAINE AVE
Mailing Address - Street 2:
Mailing Address - City:UPPER MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1948
Mailing Address - Country:US
Mailing Address - Phone:973-746-6056
Mailing Address - Fax:
Practice Address - Street 1:223 LORRAINE AVE
Practice Address - Street 2:
Practice Address - City:UPPER MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1948
Practice Address - Country:US
Practice Address - Phone:973-746-6056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ176761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty