| Jackson Pediatric Dentistry Pc | |
|
2064 W County Line Rd Jackson NJ 08527-2014 | |
| (732) 637-9805 | |
| Not Available |
| Full Name | Jackson Pediatric Dentistry Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2064 W County Line Rd, Jackson, New Jersey |
| Authorized Official Name and Position | Jacqueline Mikhly (OWNER) |
| Authorized Official Contact | 9179748445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Pediatric Dentistry Pc 2064 W County Line Rd Jackson NJ 08527-2014 Ph: (732) 637-9805 | Jackson Pediatric Dentistry Pc 2064 W County Line Rd Jackson NJ 08527-2014 Ph: (732) 637-9805 |
| NPI Number | 1588158539 |
|---|---|
| Provider Enumeration Date | 06/21/2018 |
| Last Update Date | 06/21/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588158539 | NPI | - | NPPES |
| 22DI02529300 | Other | NJ | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 22DI02529300 (New Jersey) | Primary |
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