# SOMERDALE FAMILY DENTAL ASSOCIATES PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104847805
- **Authorized official:** DR. FRANCINE J REBHUN DMD (SECRETARY)
- **Authorized official phone:** (856) 783-3499

## Contact information

- **Practice address:** 205 N WHITE HORSE PIKE, SOMERDALE, NJ 08083-1646
- **Practice address phone:** (856) 783-3499
- **Practice address fax:** (856) 783-9582
- **Mailing address:** 205 N WHITE HORSE PIKE, SOMERDALE, NJ 08083-1646
- **Mailing address phone:** (856) 783-3499
- **Mailing address fax:** (856) 783-9582

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 13496 | NJ | Yes |

## Other

- **Enumeration date:** 07/21/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2655705 | — | NJ |