Organization
HERITAGE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELENA DR. GUT (PRACTICE MANAGER)
(609) 646-3890
Entity
Organization
Contact information
Practice address
5 E JIMMIE LEEDS RD, GALLOWAY, NJ 08205-9705
(609) 646-3890
Mailing address
5 E JIMMIE LEEDS RD, GALLOWAY, NJ 08205-9705
(609) 646-3890
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/13/2021
Last updated
08/13/2021
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