| Dentrust Dental, P.a. | |
|
3452 Brody Ave Ft. Dix NJ 08640 | |
| (609) 342-6467 | |
| Not Available |
| Full Name | Dentrust Dental, P.a. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3452 Brody Ave, Ft. Dix, New Jersey |
| Authorized Official Name and Position | Amanda A Clark (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 6093426467 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentrust Dental, P.a. 6097 Easton Rd Pipersville PA 18947-1810 Ph: (445) 200-8197 | Dentrust Dental, P.a. 3452 Brody Ave Ft. Dix NJ 08640 Ph: (609) 342-6467 |
| NPI Number | 1023724044 |
|---|---|
| Provider Enumeration Date | 01/24/2023 |
| Last Update Date | 01/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023724044 | NPI | - | NPPES |
| 22D101759200 | Other | NJ | LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |