Organization
WOODBINE DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUES NATHAN DDS (DENTIST PRESIDENT)
(609) 861-2784
Entity
Organization
Contact information
Practice address
901 DEHIRSCH AVENUE, WOODBINE, NJ 08270
(609) 861-2784
(609) 861-3160
Mailing address
901 DEHIRSCH AVENUE, WOODBINE, NJ 08270
(609) 861-2784
(609) 861-3160
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI00879400
NJ
122300000X
Dentist
22DI01862600
NJ
122300000X
Dentist
Primary
22DI01877400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2743906
—
NJ
Enumeration date
03/13/2007
Last updated
08/22/2020
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