NPI 1073060612
State Street Smiles
Practice location
- Address
- 405 Main Street, Hackensack, NJ 07601
- Phone
- (201) 487-7030
- Mailing address
- 405 Main St, Hackensack, NJ 07601-5965
Authorised official
- Name
- Edward Jackson
- Title
- Doctor
- Phone
- (201) 487-7030
Registered specialties
Advanced Practice Dental Therapist
Primary
Registry record
- NPI
- 1073060612
- Entity type
- Organization
- NPI issued
- 1 Sep 2016
- Record last updated
- 1 Sep 2016
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.