Organization
BRACES AT SEA GIRT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LITTLE (MEMBER)
(732) 449-6564
Entity
Organization
Contact information
Practice address
804 HIGHWAY 71, SEA GIRT, NJ 08750-2807
(732) 449-6564
Mailing address
804 HIGHWAY 71, SEA GIRT, NJ 08750-2807
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
812501
NJ
Other
Enumeration date
05/11/2007
Last updated
08/22/2020
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