Individual
JILL THERESE BEITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4608 WESTFIELD AVE, PENNSAUKEN, NJ 08110-3030
(856) 910-0400
Mailing address
6 TENDRING RD, CHERRY HILL, NJ 08003-2122
(609) 410-5207
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DI02648200
NJ
122300000X
Dentist
DI02648201
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/16/2015
Last updated
10/10/2016
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