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Organization

PA DENTAL LLC

Active
Other names
Mercer Smiles Family Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
RICKEN PATEL DMD (OWNER)
(732) 213-0036
Entity
Organization

Contact information

Practice address
17 MAIN ST STE 301, ROBBINSVILLE, NJ 08691-1401
(732) 213-0036
Mailing address
1 EXECUTIVE DR STE 103, MONMOUTH JUNCTION, NJ 08852-2446
(732) 422-8668

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1223S0112X
Oral and Maxillofacial Surgery (Dentist)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1396005203
DENTAL OFFICE
NJ
01
1912280306
DENTAL OFFICE
NJ
Enumeration date
11/27/2017
Last updated
11/27/2017
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