Provider Demographics
NPI:1649305400
Name:METROPOLITAN DENTAL ASSOCIATION
Entity type:Organization
Organization Name:METROPOLITAN DENTAL ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZEINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-224-0310
Mailing Address - Street 1:799 ABBOTT BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024
Mailing Address - Country:US
Mailing Address - Phone:201-224-0310
Mailing Address - Fax:201-224-0660
Practice Address - Street 1:799 ABBOTT BLVD
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024
Practice Address - Country:US
Practice Address - Phone:201-224-0310
Practice Address - Fax:201-224-0660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ18623122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty