Organization
TRI-STATE DENTISTRY DEH, LLC
Active
Parent organization
TRI-STATE DENTISTRY, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRI-STATE DENTISTRY, LLC
Authorized official
SHAMIK DESAI (PARTNER)
(856) 418-5436
Entity
Organization
Contact information
Practice address
6801 BLACK HORSE PIKE STE 1000, EGG HARBOR TOWNSHIP, NJ 08234-4115
(856) 418-5436
Mailing address
6801 BLACK HORSE PIKE STE 100, EGG HARBOR TOWNSHIP, NJ 08234-4120
(856) 418-5436
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/29/2019
Last updated
03/29/2019
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