Organization
CHILDREN'S DENTAL SURGERY CENTER OF JACKSON LLC
Active
Other names
Children's Dental Surgery of Jackson
Organization subpart
No
Provider details
NPI number
Authorized official
VAN PHI LE (CREDENTIALING CONTRACTS MANAGER)
(267) 575-2321
Entity
Organization
Contact information
Practice address
27 S COOKS BRIDGE RD STE 2-3, JACKSON, NJ 08527-2462
(732) 928-1099
(732) 833-1690
Mailing address
300 WILLOWBROOK LN STE 330, WEST CHESTER, PA 19382-5594
(267) 575-2321
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
05/26/2021
Last updated
08/24/2022
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