Broderick, Tara Kimberly

Broderick, Tara Kimberly is an individual health care provider with primary practice located at 645 Main St , Hackensack NJ 07601-4712. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Broderick, Tara Kimberly can be contacted via phone (201) 488-8300.

Contact Information

Primary practice address
645 Main St Hackensack NJ 07601-4712
Phone: (201) 488-8300
Fax: (201) 488-5953
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X New Jersey

Profile Details

NPI number 1467504472
LBN Legal business name Broderick, Tara Kimberly
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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