Provider Demographics
NPI:1447035209
Name:FOUNDATION FAMILY DENTISTRY LLC
Entity type:Organization
Organization Name:FOUNDATION FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-668-5266
Mailing Address - Street 1:B5 CORNWALL DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3361
Mailing Address - Country:US
Mailing Address - Phone:732-390-1911
Mailing Address - Fax:
Practice Address - Street 1:B5 CORNWALL DR
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3361
Practice Address - Country:US
Practice Address - Phone:732-390-1911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty