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Organization
PA DENTAL LLC
Active
Organization
PA DENTAL LLC
Active
Other names
Mercer Smiles Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
RICKEN PATEL DMD (OWNER)
(732) 213-0036
Entity
Organization
Contact information
Practice address
17 MAIN ST STE 301, ROBBINSVILLE, NJ 08691-1401
(732) 213-0036
Mailing address
1 EXECUTIVE DR STE 103, MONMOUTH JUNCTION, NJ 08852-2446
(732) 422-8668
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396005203
DENTAL OFFICE
NJ
01
—
1912280306
DENTAL OFFICE
NJ
Enumeration date
11/27/2017
Last updated
11/27/2017
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