Organization
MARLTON FAMILY DENTISTRY LLC
Active
Other names
Marlton Family Dentistry, State of the Art Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAKE ENTRALGO DMD (OWNER)
(281) 851-6064
Entity
Organization
Contact information
Practice address
560A LIPPINCOTT DR BLDG B, MARLTON, NJ 08053
(856) 985-1800
(856) 985-7170
Mailing address
560A LIPPINCOTT DR, BLDG B, MARLTON, NJ 08053
(856) 985-1800
(856) 985-7170
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
22DI02666400
NJ
Other
Enumeration date
11/30/2017
Last updated
06/16/2018
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