Organization
SOUTH JERSEY PEDIATRIC DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDALIZ BRISTOL MARTIR D.M.D. (PEDIATRIC DENTIST)
(856) 839-7019
Entity
Organization
Contact information
Practice address
2550 S MAIN RD, VINELAND, NJ 08360-7138
(856) 213-4400
(856) 213-4401
Mailing address
2550 S MAIN RD, VINELAND, NJ 08360-7138
(856) 213-4400
(856) 213-4401
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
08/30/2013
Last updated
05/06/2022
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