Correctional Dental Associates
Exclusive Provider Organization in Trenton, NJ. Organization (NPI-2).
NPI number1194920587
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1194920587
- Entity type
- Organization (NPI-2)
- Legal business name
- Correctional Dental Associates
- Organization subpart
- No
- Enumeration date
- Jun 18, 2007
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302F00000X | Exclusive Provider Organization | – | NJ | Yes |
Practice location
192 W State StTrenton, NJ 08608-1104
Phone 609-599-2800 · Fax 609-599-4128
Mailing address
192 W State StTrenton, NJ 08608-1104
Phone 609-599-2800 · Fax 609-599-4128
Authorized official
Leslie Ambrose Hayling
President
6095992800
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