Larisa Ilyutovich Dds Pc

LBN: Larisa Ilyutovich Dds Pc
Larisa Ilyutovich Dds Pc is an health care organization with primary practice located at 301 Bridge Plaza North 2Nd Flr, Fort Lee NJ 07024. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Larisa Ilyutovich Dds Pc can be contacted via phone (201) 346-4660, or through Ilyutovich, Larisa via phone (201) 346-4660.

Contact Information

Primary practice address
301 Bridge Plaza North 2Nd Flr Fort Lee NJ 07024
Phone: (201) 346-4660
Fax: (201) 346-1116
Website:
Map and Directions
Authorized official contact:
Name: Ilyutovich, Larisa Doctor of Dental Surgery (DDS)
Phone: (201) 346-4660

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DI020299 New Jersey

Profile Details

NPI number 1609954064
LBN Legal business name Larisa Ilyutovich Dds Pc
DBA Doing business as
Authorized official Ilyutovich, Larisa Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 2nd, 2006
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609954064 NPPES
New Jersey MEDICAID 8797404

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