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Organization
MOORESTOWN SMILE CENTER LLC
Active
Organization
MOORESTOWN SMILE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALIYA KHAN DDS (OWNER)
(856) 638-5266
Entity
Organization
Contact information
Practice address
740 MARNE HWY, SUIT 106, MOORESTOWN, NJ 08057-3126
(856) 638-5266
(856) 638-5355
Mailing address
740 MARNE HWY, SUIT 106, MOORESTOWN, NJ 08057-3126
(856) 638-5266
(856) 638-5355
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02282300
NJ
332BC3200X
Customized Equipment (DME)
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942370143
INDIVIUAL NPI
—
Enumeration date
12/03/2016
Last updated
01/05/2023
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