# ADDIEGO FAMILY DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cedar Creek Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821412800
- **Authorized official:** DR. JESSICA KIM BRAMLETTE DMD (OWNER)
- **Authorized official phone:** (609) 489-3360

## Contact information

- **Practice address:** 950 ATLANTIC CITY BLVD, SUITE 13, BAYVILLE, NJ 08721-3564
- **Practice address phone:** (732) 269-1046
- **Mailing address:** 950 ATLANTIC CITY BLVD, SUITE 13, BAYVILLE, NJ 08721-3564
- **Mailing address phone:** (732) 269-1046

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 22DI00971000 | NJ | — |
| 1223G0001X | General Practice Dentistry | 22DI02107800 | NJ | Yes |
| 1223G0001X | General Practice Dentistry | 22DI02328300 | NJ | — |

## Other

- **Enumeration date:** 02/11/2014
- **Last updated:** 02/11/2014