| Organization Name: | LAWRENCE M BODENSTEIN DMD |
| NPI Number: | 1568860542 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAWRENCE MICHAEL BODENSTEIN (OWNER/DENTIST) |
| Mailing Address: | 253 Boulevard Ste 1 Hasbrouck Heights |
| State: | NJ US |
| Postal Code: | 076041939 |
| Phone Number: | 2012881788 |
| Fax Number: | 2012881909 |
| NPI Enumeration Date: | 12/08/2014 |
| NPI Last Update Date: | 12/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | DI-015614 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |