Organization
NORTHEASTERN DENTISTRY AT BELLMAWR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUJIT KONDAPANENI (PRESIDENT)
(856) 325-0560
Entity
Organization
Contact information
Practice address
815 CREEK ROAD, BELLMAWR, NJ 08031
(856) 325-0560
Mailing address
218 SUMMIT RD, MOUNT LAUREL, NJ 08054-4748
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/07/2023
Last updated
07/07/2023
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