# ACADEMY DENTAL GROUP, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Cosmetic & Laser Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720655863
- **Authorized official:** JASON LEE (OWNER)
- **Authorized official phone:** (973) 328-0022

## Contact information

- **Practice address:** 4 MARVIN ST, DOVER, NJ 07801-3735
- **Practice address phone:** (973) 328-0022
- **Practice address fax:** (973) 328-0988
- **Mailing address:** 4 MARVIN ST, DOVER, NJ 07801-3735
- **Mailing address phone:** (973) 328-0022

## Taxonomy

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

## Other

- **Enumeration date:** 06/08/2021
- **Last updated:** 06/08/2021