Organization
SOUTH JERSEY CENTER FOR ADVANCED DENTISTRY, LLC
Active
Other names
SJ Center for Advanced Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LADERRICK BULLOCK DMD (OWNER)
(856) 988-7773
Entity
Organization
Contact information
Practice address
750 ROUTE 73 S STE 209, MARLTON, NJ 08053-4133
(856) 988-7773
Mailing address
20 BOX TURTLE LN, SICKLERVILLE, NJ 08081-5682
(973) 202-0266
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
—
—
Other
Enumeration date
06/01/2020
Last updated
06/01/2020
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