Provider Demographics
NPI:1043017858
Name:MORRISTON DENTAL GROUP LLC
Entity type:Organization
Organization Name:MORRISTON DENTAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-247-0415
Mailing Address - Street 1:511 47TH AVE APT 3E
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5790
Mailing Address - Country:US
Mailing Address - Phone:203-247-0415
Mailing Address - Fax:
Practice Address - Street 1:101 MADISON AVE STE 400
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7305
Practice Address - Country:US
Practice Address - Phone:973-539-3911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty