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General NPI Number Information
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NPI Number | 1003046921
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Entity Type | Organization
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Legal Business Name | HADDONFIELD FAMILY DENTISTRY
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 07/27/2009
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Provider Practice Location Address
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Address Line | 5 N. HADDON AVENUE
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City | HADDONFIELD
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State | NJ
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Zip | 08033-2437
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Country | US
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Telephone | 856-429-5612
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Fax | 856-429-8388
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Provider Business Mailing Address
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Address Line | 5 N. HADDON AVENUE
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City | HADDONFIELD
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State | NJ
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Zip | 08033-2437
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Country | US
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Telephone | 856-429-5612
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Fax | 856-429-8388
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SUSAN A. TOMASINI
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Credential |
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Telephone | 856-429-5612
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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