Organization
EASTERN DENTAL OF MARLTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEWIS PROFFITT D.M.D (DIRECTOR)
(856) 983-5400
Entity
Organization
Contact information
Practice address
8001 LINCOLN DR W STE A, MARLTON, NJ 08053-3211
(856) 983-5400
Mailing address
1030 SAINT GEORGES AVE, AVENEL, NJ 07001-1390
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
11364
NJ
1223P0300X
Periodontics
09460
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
07879
NJ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
23068
NJ
Other
Enumeration date
03/26/2007
Last updated
09/11/2025
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