Healthcare Provider Details

I. General information

NPI: 1992808547
Provider Name (Legal Business Name): BERNARD CALEM DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 S CHURCH ST SUITE 7
MOORESTOWN NJ
08057-2773
US

IV. Provider business mailing address

30 JACKSON RD STE A5
MEDFORD NJ
08055-9279
US

V. Phone/Fax

Practice location:
  • Phone: 856-439-1200
  • Fax: 856-439-1106
Mailing address:
  • Phone: 609-953-3700
  • Fax: 609-953-3700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number22DI02086401
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDI02086400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: