Pangborn Family Dentistry LLC
Dentist, General Practice in Hackensack, NJ. Organization (NPI-2).
NPI number1982180360
StatusActive
Last updated in NPPESJul 18, 2018
Details
- NPI
- 1982180360
- Entity type
- Organization (NPI-2)
- Legal business name
- Pangborn Family Dentistry LLC
- Organization subpart
- No
- Enumeration date
- Jul 18, 2018
- Last updated
- Jul 18, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
| 1223E0200X | Dentist, Endodontics | – | – | |
| 1223P0221X | Dentist, Pediatric Dentistry | – | – | |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | – | – |
Practice location
35 Pangborn PlHackensack, NJ 07601-4506
Phone 201-801-0101 · Fax 201-488-9130
Mailing address
520 Summit AveHackensack, NJ 07601-1550
Phone 201-488-9030 · Fax 201-488-9130
Authorized official
Twaniqua Chisolm
Manager
2014889030
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