Organization
TRI-STATE DENTISTRY VDE, LLC
Active
Parent organization
TRI-STATE DENTISTRY, LLC
Other names
Value Dental Centers
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRI-STATE DENTISTRY, LLC
Authorized official
DR. SHAMIK N DESAI DMD (PARTNER)
(856) 418-5436
Entity
Organization
Contact information
Practice address
2000 CLEMENTS BRIDGE RD STE 10, DEPTFORD, NJ 08096-2016
(856) 418-5436
Mailing address
1070 W LANDIS AVE, VINELAND, NJ 08360-3422
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NZ
—
Enumeration date
03/27/2019
Last updated
03/29/2019
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