Organization
STATE OF THE ART SMILES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA ADDIEGO MOORE DMD (PRESIDENT/OWNER)
(856) 985-1800
Entity
Organization
Contact information
Practice address
560A LIPPINCOTT DR, MARLTON, NJ 08053
(856) 985-1880
(856) 985-7170
Mailing address
560A LIPPINCOTT DR, MARLTON, NJ 08053
(856) 985-1880
(856) 985-7170
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DI01771700
NJ
122300000X
Dentist
DI02582400
NJ
1223P0300X
Periodontics
DI02514400
NJ
Other
Enumeration date
12/12/2014
Last updated
12/12/2014
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