# NEWARK DENTAL SPA LLC

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

## Provider details

- **NPI number:** 1568197291
- **Authorized official:** KHALED G ELDIN DDS (DENTIST)
- **Authorized official phone:** (609) 547-3232

## Contact information

- **Practice address:** 164 FERRY ST, NEWARK, NJ 07105-2158
- **Practice address phone:** (609) 547-3232
- **Practice address fax:** (609) 594-1179
- **Mailing address:** 164 FERRY ST, NEWARK, NJ 07105-2158
- **Mailing address phone:** (609) 547-3232

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 07/18/2022
- **Last updated:** 07/20/2022