# PA DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mercer Smiles Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295249456
- **Authorized official:** RICKEN PATEL DMD (OWNER)
- **Authorized official phone:** (732) 213-0036

## Contact information

- **Practice address:** 17 MAIN ST STE 301, ROBBINSVILLE, NJ 08691-1401
- **Practice address phone:** (732) 213-0036
- **Mailing address:** 1 EXECUTIVE DR STE 103, MONMOUTH JUNCTION, NJ 08852-2446
- **Mailing address phone:** (732) 422-8668

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |

## Other

- **Enumeration date:** 11/27/2017
- **Last updated:** 11/27/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1396005203 | DENTAL OFFICE | NJ |
| 01 | — | 1912280306 | DENTAL OFFICE | NJ |