Organization
NJ DFC ORTHODONTICS, LLC
Active
Parent organization
NJ DENTISTRY FOR CHILDREN, P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
NJ DENTISTRY FOR CHILDREN, P.A.
Authorized official
PHI LE (CREDENTIALING CONTRACTS MANAGER)
(267) 575-2321
Entity
Organization
Contact information
Practice address
870 RIVER AVE, LAKEWOOD, NJ 08701-5280
(484) 787-2946
Mailing address
300 WILLOWBROOK LN STE 330, WEST CHESTER, PA 19382-5594
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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