Organization
OPTIMA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIJI SEETHARAMAN DMD (OWNER)
(732) 666-7415
Entity
Organization
Contact information
Practice address
222 COMMERCE CIR, BRISTOL, PA 19007-3113
(732) 666-7415
Mailing address
222 COMMERCE CIR, BRISTOL, PA 19007-3113
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DS039249
STATE LICENSE
PA
Enumeration date
07/15/2016
Last updated
07/15/2016
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