# NOVASACK FAMILY DENTAL LLC

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

## Provider details

- **NPI number:** 1548636400
- **Authorized official:** DR. GEORGE NOVASACK DMD (PRESIDENT)
- **Authorized official phone:** (609) 927-5454

## Contact information

- **Practice address:** 560 SHORE RD, SOMERS POINT, NJ 08244-2447
- **Practice address phone:** (609) 927-5454
- **Practice address fax:** (609) 927-6369
- **Mailing address:** 560 SHORE RD, SOMERS POINT, NJ 08244-2447
- **Mailing address phone:** (609) 927-5454
- **Mailing address fax:** (609) 927-6369

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 22DI00995300 | NJ | Yes |
| 1223G0001X | General Practice Dentistry | 22DI02608500 | NJ | — |

## Other

- **Enumeration date:** 08/14/2015
- **Last updated:** 08/14/2015