Organization
GARDEN STATE SMILES OF BRICK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA PETROLITO (OFFICE MGR)
(732) 477-5770
Entity
Organization
Contact information
Practice address
525 ROUTE 70 E, SUITE 1A, BRICK, NJ 08723
(732) 477-5770
(732) 477-3433
Mailing address
525 ROUTE 70, SUITE 1A, BRICK, NJ 08723-4022
(732) 477-5770
(732) 477-3433
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
21211
NJ
1223G0001X
General Practice Dentistry
9434
NJ
1223G0001X
General Practice Dentistry
Primary
9440
NJ
Other
Enumeration date
07/29/2016
Last updated
07/29/2016
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