# MAGIC DENTAL CAMDEN, LLC

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

## Provider details

- **NPI number:** 1235610882
- **Authorized official:** DR. NATALYA KONDRATYEVA DDS (OWNER)
- **Authorized official phone:** (856) 963-0315

## Contact information

- **Practice address:** 433 MARKET ST STE 102, CAMDEN, NJ 08102-1572
- **Practice address phone:** (856) 963-2369
- **Practice address fax:** (856) 963-2369
- **Mailing address:** 433 MARKET ST STE 102, CAMDEN, NJ 08102-1572
- **Mailing address phone:** (856) 963-2369
- **Mailing address fax:** (856) 963-2369

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 22DI02018400 | NJ | Yes |

## Other

- **Enumeration date:** 08/22/2018
- **Last updated:** 01/19/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0617415 | — | NJ |