Organization
HOLDBROOK PEDIATRIC DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WENDELL HOLDBROOK DMD (OWNER)
(856) 783-0444
Entity
Organization
Contact information
Practice address
553 BECKETT RD, SUITE 604, SWEDESBORO, NJ 08085-1565
(856) 556-4020
(856) 241-1251
Mailing address
250 HADDONFIELD BERLIN RD, SUITE 101, GIBBSBORO, NJ 08026-1228
(856) 783-0444
(856) 241-1251
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
22DI02445300
NJ
1223P0221X
Pediatric Dentistry
Primary
22DI02298200
NJ
1223P0221X
Pediatric Dentistry
22DI02379500
NJ
1223P0221X
Pediatric Dentistry
22DI02463800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0212768
—
NJ
Enumeration date
01/17/2013
Last updated
01/17/2013
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