| Little Smiles Pediatric Dentistry Of South Jersey | |
|
1206 W Sherman Ave Ste 4d Vineland NJ 08360-6911 | |
| (856) 368-2800 | |
| (856) 412-5100 |
| Full Name | Little Smiles Pediatric Dentistry Of South Jersey |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1206 W Sherman Ave Ste 4d, Vineland, New Jersey |
| Authorized Official Name and Position | Darlene L Mander (CREDENTIALING/AR) |
| Authorized Official Contact | 8562078406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Little Smiles Pediatric Dentistry Of South Jersey 1206 W Sherman Ave Ste 4d Vineland NJ 08360-6911 Ph: (856) 368-2800 | Little Smiles Pediatric Dentistry Of South Jersey 1206 W Sherman Ave Ste 4d Vineland NJ 08360-6911 Ph: (856) 368-2800 |
| NPI Number | 1295582005 |
|---|---|
| Provider Enumeration Date | 05/01/2024 |
| Last Update Date | 09/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295582005 | NPI | - | NPPES |
| 06371-03 | Other | NJ | SPECIALTY PERMIT |
| 0490644 | Medicaid | NJ | |
| 22DI02457700 | Other | NJ | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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