# IN-HOUSE DENTAL SERVICES

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

## Provider details

- **NPI number:** 1740505908
- **Authorized official:** DR. THERESA DANTONIO DDS (DENTIST/OWNER)
- **Authorized official phone:** (732) 363-1411

## Contact information

- **Practice address:** 975 BENNETTS MILLS RD, JACKSON, NJ 08527-2225
- **Practice address phone:** (732) 363-1411
- **Practice address fax:** (732) 363-1401
- **Mailing address:** 24 LEONE BLVD, JACKSON, NJ 08527
- **Mailing address phone:** (732) 363-1411
- **Mailing address fax:** (732) 363-1401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | DI02081701 | NJ | — |
| 310400000X | Assisted Living Facility | DI19441 | NJ | Yes |

## Other

- **Enumeration date:** 03/31/2010
- **Last updated:** 03/31/2010