# MOORESTOWN SMILE CENTER LLC

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

## Provider details

- **NPI number:** 1386187714
- **Authorized official:** DR. ALIYA KHAN DDS (OWNER)
- **Authorized official phone:** (856) 638-5266

## Contact information

- **Practice address:** 740 MARNE HWY, SUIT 106, MOORESTOWN, NJ 08057-3126
- **Practice address phone:** (856) 638-5266
- **Practice address fax:** (856) 638-5355
- **Mailing address:** 740 MARNE HWY, SUIT 106, MOORESTOWN, NJ 08057-3126
- **Mailing address phone:** (856) 638-5266
- **Mailing address fax:** (856) 638-5355

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 22DI02282300 | NJ | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 12/03/2016
- **Last updated:** 01/05/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1942370143 | INDIVIUAL NPI | — |