Organization
AESTHETIC SMILES OF WAYNE PROFESSIONAL ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY ELLIS III (OWNER OFFICE MANAGER)
(973) 696-2444
Entity
Organization
Contact information
Practice address
896 VALLEY ROAD, WAYNE, NJ 07470-2971
(973) 696-2444
(973) 696-2888
Mailing address
896 VALLEY ROAD, WAYNE, NJ 07470-2971
(973) 696-2444
(973) 696-2888
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02134100
NJ
Other
Enumeration date
07/25/2008
Last updated
07/25/2008
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