| South Jersey Dental Sleep Center Llc | |
|
76 N Main St Medford NJ 08055-2720 | |
| (609) 953-7199 | |
| (609) 953-0314 |
| Full Name | South Jersey Dental Sleep Center Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 76 N Main St, Medford, New Jersey |
| Authorized Official Name and Position | Ken Hoover (OWNER) |
| Authorized Official Contact | 6099537199 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Jersey Dental Sleep Center Llc 76 N Main St Medford NJ 08055-2720 Ph: (609) 953-7199 | South Jersey Dental Sleep Center Llc 76 N Main St Medford NJ 08055-2720 Ph: (609) 953-7199 |
| NPI Number | 1497101430 |
|---|---|
| Provider Enumeration Date | 05/09/2016 |
| Last Update Date | 05/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497101430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | DI01615200 (New Jersey) | Primary |
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