Organization
PEARLY WHITES SPEC LLC
Active
Other names
Pearly Whites
Organization subpart
No
Provider details
NPI number
Authorized official
KATE RODRIGUES (BILLING COORDINATOR)
(973) 578-8788
Entity
Organization
Contact information
Practice address
501 SPRINGFIELD AVE, BERKELEY HEIGHTS, NJ 07922
(973) 578-8788
Mailing address
501B SPRINGFIELD AVE, BERKELEY HEIGHTS, NJ 07922-1180
(973) 578-8788
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
12/01/2015
Last updated
02/25/2020
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