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Organization
NEW JERSEY DENTAL GROUP, PC
Active
Organization
NEW JERSEY DENTAL GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WINKLER (REVENUE CYCLE MANAGER)
(717) 590-1513
Entity
Organization
Contact information
Practice address
101 N POINTE BLVD, SUITE 202, LANCASTER, PA 17601-4108
(717) 590-1500
(484) 731-9015
Mailing address
101 N POINTE BLVD, SUITE 202, LANCASTER, PA 17601-4108
(717) 590-1500
(484) 731-9015
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
NULL
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
NULL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
09/04/2015
Last updated
09/04/2015
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