Healthcare Provider Details

I. General information

NPI: 1760989727
Provider Name (Legal Business Name): VOORHEES DENTAL SMILES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2018
Last Update Date: 04/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 WHITE HORSE RD W
VOORHEES NJ
08043-3610
US

IV. Provider business mailing address

28 TUDOR CT
MARLTON NJ
08053-2085
US

V. Phone/Fax

Practice location:
  • Phone: 856-784-5061
  • Fax:
Mailing address:
  • Phone: 908-230-6762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number22DI02549900
License Number StateNJ

VIII. Authorized Official

Name: DR. SWETHA BUDDA
Title or Position: OWNER
Credential: DMD
Phone: 908-230-6762