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General NPI Number Information
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NPI Number | 1245709211
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Entity Type | Organization
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Legal Business Name | SPLENDID SMILES FAMILY DENTISTRY
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Dates
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Enumeration Date | 11/19/2018
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 495 W VETERANS HWY STE 1
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City | JACKSON
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State | NJ
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Zip | 08527-3757
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Country | US
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Telephone | 848-222-1455
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Fax | 848-222-1454
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Provider Business Mailing Address
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Address Line | 495 W VETERANS HWY STE 1
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City | JACKSON
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State | NJ
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Zip | 08527-3757
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Country | US
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Telephone | 848-222-1455
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Fax | 848-222-1454
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Authorized Official
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Title or Position | CO-PRESIDENT
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Name | DR. ALLISON R CORAPI
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Credential | DMD
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Telephone | 848-222-1455
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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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