Provider Demographics
NPI:1841923877
Name:WESTWOOD PERIODONTICS,PC
Entity type:Organization
Organization Name:WESTWOOD PERIODONTICS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRIYU
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-664-3023
Mailing Address - Street 1:354 OLD HOOK RD STE 201
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-3248
Mailing Address - Country:US
Mailing Address - Phone:201-664-3023
Mailing Address - Fax:201-664-0912
Practice Address - Street 1:354 OLD HOOK RD STE 201
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3248
Practice Address - Country:US
Practice Address - Phone:201-664-3023
Practice Address - Fax:201-664-0912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-07
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty