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General NPI Number Information
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NPI Number | 1265229124
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Entity Type | Organization
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Legal Business Name | DENTAL HEALTH ASSOCIATES SOUTH JERSEY, PA
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Dates
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Enumeration Date | 04/23/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 2200 STATE ROUTE 66
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City | NEPTUNE
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State | NJ
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Zip | 07753-4062
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Country | US
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Telephone | 732-775-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 STATE ROUTE 66
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City | NEPTUNE
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State | NJ
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Zip | 07753-4062
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Country | US
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Telephone | 732-775-7800
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CREDENTIALING
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Name | SIMONE WILSON-ADELEKE
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Credential | MPA-PPA
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Telephone | 848-326-8840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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