Provider Demographics
NPI:1861614927
Name:ASSOCIATES IN IMPLANT AND COSMETIC DENTISTRY PC
Entity type:Organization
Organization Name:ASSOCIATES IN IMPLANT AND COSMETIC DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:KURPIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-447-9700
Mailing Address - Street 1:545 ROUTE 17 S
Mailing Address - Street 2:# 2007
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450
Mailing Address - Country:US
Mailing Address - Phone:201-447-9700
Mailing Address - Fax:201-447-4099
Practice Address - Street 1:545 ROUTE 17 S
Practice Address - Street 2:# 2007
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450
Practice Address - Country:US
Practice Address - Phone:201-447-9700
Practice Address - Fax:201-447-4099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ088671223P0300X
NJ129551223P0700X
NJ153621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty