Organization
MAGIC DENTAL CAMDEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATALYA KONDRATYEVA DDS (OWNER)
(856) 963-0315
Entity
Organization
Contact information
Practice address
433 MARKET ST STE 102, CAMDEN, NJ 08102-1572
(856) 963-2369
(856) 963-2369
Mailing address
433 MARKET ST STE 102, CAMDEN, NJ 08102-1572
(856) 963-2369
(856) 963-2369
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02018400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0617415
—
NJ
Enumeration date
08/22/2018
Last updated
01/19/2021
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