Provider Demographics
NPI:1902928971
Name:VILLAGE DENTAL,P.A.
Entity Type:Organization
Organization Name:VILLAGE DENTAL,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARZINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-440-9190
Mailing Address - Street 1:255 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-1598
Mailing Address - Country:US
Mailing Address - Phone:201-440-9190
Mailing Address - Fax:201-440-1288
Practice Address - Street 1:255 MAIN ST
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07660-1598
Practice Address - Country:US
Practice Address - Phone:201-440-9190
Practice Address - Fax:201-440-1288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0181751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty