Dental Of Clementon
Dentist, General Practice in Clementon, NJ. Organization (NPI-2).
NPI number1205453032
StatusActive
Last updated in NPPESJun 27, 2020
Details
- NPI
- 1205453032
- Entity type
- Organization (NPI-2)
- Legal business name
- Dental Of Clementon
- Organization subpart
- No
- Enumeration date
- Jun 27, 2020
- Certification date
- Jun 27, 2020
- Last updated
- Jun 27, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
| 122300000X | Dentist | – | – | |
| 1223D0001X | Dentist, Dental Public Health | – | – |
Practice location
250 Gibbsboro RdClementon, NJ 08021-4130
Phone 856-783-3300
Mailing address
250 Gibbsboro RdClementon, NJ 08021-4130
Phone 856-783-3300
Authorized official
Samantha Wolff
Owner
8567833300
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