# PENNINGTON DENTAL CARE LLC

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

## Provider details

- **NPI number:** 1386910040
- **Authorized official:** DR. YATIN KHANNA DDS (MEMBER)
- **Authorized official phone:** (718) 915-3713

## Contact information

- **Practice address:** 2425 PENNINGTON RD, PENNINGTON, NJ 08534-5228
- **Practice address phone:** (718) 915-3713
- **Practice address fax:** (866) 894-5881
- **Mailing address:** 2425 PENNINGTON RD, PENNINGTON, NJ 08534-5228
- **Mailing address phone:** (718) 915-3713
- **Mailing address fax:** (866) 894-5881

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 21759 | NJ | — |
| 122300000X | Dentist | 23707 | NJ | Yes |
| 1223P0700X | Prosthodontics | 23509 | NJ | — |

## Other

- **Enumeration date:** 03/28/2012
- **Last updated:** 03/28/2012