| South Jersey Pediatric Dental, Llc | |
|
2550 S Main Rd Vineland NJ 08360-7138 | |
| (856) 213-4400 | |
| (856) 213-4401 |
| Full Name | South Jersey Pediatric Dental, Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 2550 S Main Rd, Vineland, New Jersey |
| Authorized Official Name and Position | Brendaliz Bristol Martir (PEDIATRIC DENTIST) |
| Authorized Official Contact | 8568397019 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Jersey Pediatric Dental, Llc 2550 S Main Rd Vineland NJ 08360-7138 Ph: (856) 213-4400 | South Jersey Pediatric Dental, Llc 2550 S Main Rd Vineland NJ 08360-7138 Ph: (856) 213-4400 |
| NPI Number | 1598199101 |
|---|---|
| Provider Enumeration Date | 08/30/2013 |
| Last Update Date | 05/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598199101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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