| Woodbine Dental Pa | |
|
901 Dehirsch Avenue Woodbine NJ 08270 | |
| (609) 861-2784 | |
| (609) 861-3160 |
| Full Name | Woodbine Dental Pa |
|---|---|
| Speciality | Dentist |
| Location | 901 Dehirsch Avenue, Woodbine, New Jersey |
| Authorized Official Name and Position | Jacques Nathan (DENTIST PRESIDENT) |
| Authorized Official Contact | 6098612784 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodbine Dental Pa 901 Dehirsch Avenue Woodbine NJ 08270 Ph: (609) 861-2784 | Woodbine Dental Pa 901 Dehirsch Avenue Woodbine NJ 08270 Ph: (609) 861-2784 |
| NPI Number | 1700919594 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700919594 | NPI | - | NPPES |
| 2743906 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 22DI00879400 (New Jersey) | Secondary |
| 122300000X | Dentist | 22DI01877400 (New Jersey) | Primary |
| 122300000X | Dentist | 22DI01862600 (New Jersey) | Secondary |