Organization
RIVERSIDE PEDIATRIC DENTISTRY AND ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHLEY LEBAK DMD (PEDIATRIC DENTIST)
(609) 947-3526
Entity
Organization
Contact information
Practice address
30 JACKSON RD STE B2, MEDFORD, NJ 08055-9280
(609) 947-3526
Mailing address
757 WESTFIELD RD, MOORESTOWN, NJ 08057-2139
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
05/07/2025
Last updated
10/20/2025
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