Organization
GARDEN STATE SMILES OF BRICK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VLAD DETINICH DMD (PRESIDENT)
(732) 322-9297
Entity
Organization
Contact information
Practice address
525 ROUTE 70, BRICK, NJ 08723
(732) 477-5770
Mailing address
525 NEW JERSEY AVE # 70, BRICK, NJ 08724-1413
(732) 477-5770
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DI021211
NJ
Other
Enumeration date
03/02/2016
Last updated
03/02/2016
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