# CHURCH STREET FAMILY AND COSMETIC DENTISTRY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1801124110
- **Authorized official:** DR. VENETIA ZERVOS DDS (DENTIST/OWNER)
- **Authorized official phone:** (856) 778-2700

## Contact information

- **Practice address:** 817 S CHURCH ST, MOUNT LAUREL, NJ 08054-2503
- **Practice address phone:** (856) 778-2700
- **Mailing address:** 817 S CHURCH ST, MOUNT LAUREL, NJ 08054-2503
- **Mailing address phone:** (856) 778-2700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 17105 | NJ | Yes |

## Other

- **Enumeration date:** 11/24/2009
- **Last updated:** 11/24/2009