| South Jersey Center For Advanced Dentistry, Llc | |
|
750 Route 73 S Ste 209 Marlton NJ 08053-4133 | |
| (856) 988-7773 | |
| Not Available |
| Full Name | South Jersey Center For Advanced Dentistry, Llc |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 750 Route 73 S Ste 209, Marlton, New Jersey |
| Authorized Official Name and Position | Laderrick Bullock (OWNER) |
| Authorized Official Contact | 8569887773 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Jersey Center For Advanced Dentistry, Llc 20 Box Turtle Ln Sicklerville NJ 08081-5682 Ph: (973) 202-0266 | South Jersey Center For Advanced Dentistry, Llc 750 Route 73 S Ste 209 Marlton NJ 08053-4133 Ph: (856) 988-7773 |
| NPI Number | 1760006209 |
|---|---|
| Provider Enumeration Date | 06/01/2020 |
| Last Update Date | 06/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760006209 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | (* (Not Available)) | Primary |
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