Provider Demographics
NPI:1548930035
Name:REFINED DENTAL PC
Entity type:Organization
Organization Name:REFINED DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:
Authorized Official - Last Name:YAZIGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-767-7775
Mailing Address - Street 1:6B TRIUMPH CT
Mailing Address - Street 2:
Mailing Address - City:EAST RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07073-1144
Mailing Address - Country:US
Mailing Address - Phone:732-775-1492
Mailing Address - Fax:
Practice Address - Street 1:514 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:AVON BY THE SEA
Practice Address - State:NJ
Practice Address - Zip Code:07717-1157
Practice Address - Country:US
Practice Address - Phone:732-775-1492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty