Organization
CENTRAL JERSEY PEDIATRIC DENTISTRY & ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE MAY BACKHAUS D.M.D. (OWNER/ PEDIATRIC DENTIST)
(732) 257-5588
Entity
Organization
Contact information
Practice address
176 SUMMERHILL RD, EAST BRUNSWICK, NJ 08816-4908
(732) 257-5588
(732) 257-9189
Mailing address
176 SUMMERHILL RD, EAST BRUNSWICK, NJ 08816-4908
(732) 257-5588
(732) 257-9189
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22DI02292000
NJ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
22DI02295100
NJ
Other
Enumeration date
11/14/2008
Last updated
11/14/2008
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