Individual
MRS. CLARISSA SOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDA
Contact information
Practice address
1001 LAUREL OAK RD STE C2, VOORHEES, NJ 08043-3512
(856) 783-3515
(856) 783-3517
Mailing address
3030 GARFIELD AVE, MILLVILLE, NJ 08332-7641
(609) 431-3394
(856) 367-7057
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
200076
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200076
CERTIFIED DENTAL ASSISTANT
NJ
01
—
639755
DENTAL RADIOGRAPHY LICENSE
NJ
Enumeration date
03/19/2011
Last updated
03/19/2011
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