Provider Demographics
NPI:1881810935
Name:BERLIN PLAZA DENTAL ASSOCIATES, L.L.P.
Entity type:Organization
Organization Name:BERLIN PLAZA DENTAL ASSOCIATES, L.L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:DUNOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:856-768-5151
Mailing Address - Street 1:116 WALKER AVE
Mailing Address - Street 2:BERLIN CIRCLE PLAZA
Mailing Address - City:WEST BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08091-1424
Mailing Address - Country:US
Mailing Address - Phone:856-768-5151
Mailing Address - Fax:856-768-2966
Practice Address - Street 1:116 WALKER AVE
Practice Address - Street 2:BERLIN CIRCLE PLAZA
Practice Address - City:WEST BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08091-1424
Practice Address - Country:US
Practice Address - Phone:856-768-5151
Practice Address - Fax:856-768-2966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty