Provider Demographics
NPI:1134350648
Name:E-PLANT DENTAL, P.C.
Entity type:Organization
Organization Name:E-PLANT DENTAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:D
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-943-2828
Mailing Address - Street 1:118 BROAD AVE
Mailing Address - Street 2:#N-10
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-2717
Mailing Address - Country:US
Mailing Address - Phone:201-943-2828
Mailing Address - Fax:201-943-2825
Practice Address - Street 1:118 BROAD AVE
Practice Address - Street 2:#N-10
Practice Address - City:PALISADES PARK
Practice Address - State:NJ
Practice Address - Zip Code:07650-2717
Practice Address - Country:US
Practice Address - Phone:201-943-2828
Practice Address - Fax:201-943-2825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI023625001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty