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General NPI Number Information
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NPI Number | 1194432609
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Entity Type | Organization
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Legal Business Name | DENTAL ARTS & WELLNESS LLC
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Dates
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Enumeration Date | 11/03/2022
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Last Update Date | 11/03/2022
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Provider Practice Location Address
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Address Line | 524 LIPPINCOTT DR STE B
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City | EVESHAM
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State | NJ
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Zip | 08053-4804
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Country | US
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Telephone | 856-596-3200
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Fax | 856-596-3256
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Provider Business Mailing Address
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Address Line | 1634 PULASKI DR
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City | BLUE BELL
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State | PA
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Zip | 19422-3673
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | JESSICA SCORDAMAGLIA
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Credential | DMD
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Telephone | 267-337-5592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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