Organization
ACORN DENTAL SLEEP MEDICINE CENTERS LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK R VAN ISTENDAL JR. D.D.S. (OWNER)
(856) 983-0060
Entity
Organization
Contact information
Practice address
100 CENTRE BLVD, SUITE J, MARLTON, NJ 08053-4128
(856) 983-0060
(856) 983-3356
Mailing address
100 CENTRE BLVD, SUITE J, MARLTON, NJ 08053-4128
(856) 983-0060
(856) 983-3356
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
22DI00903200
NJ
Other
Enumeration date
09/24/2014
Last updated
09/24/2014
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