| Southjerseydentistry Llc | |
|
368 S White Horse Pike Berlin NJ 08009-1954 | |
| (856) 240-0406 | |
| Not Available |
| Full Name | Southjerseydentistry Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 368 S White Horse Pike, Berlin, New Jersey |
| Authorized Official Name and Position | Kosha Shah (MANAGER) |
| Authorized Official Contact | 8562400406 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southjerseydentistry Llc 368 S White Horse Pike Berlin NJ 08009-1954 Ph: (856) 240-0406 | Southjerseydentistry Llc 368 S White Horse Pike Berlin NJ 08009-1954 Ph: (856) 240-0406 |
| NPI Number | 1821491317 |
|---|---|
| Provider Enumeration Date | 09/29/2014 |
| Last Update Date | 09/29/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821491317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 22DI02287500 (New Jersey) | Primary |
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