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General NPI Number Information
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NPI Number | 1710094230
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Entity Type | Organization
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Legal Business Name | ALPHA DENTAL ASSOCS PA
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 08/03/2007
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Provider Practice Location Address
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Address Line | 2103 BRANCH PIKE
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City | CINNAMINSON
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State | NJ
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Zip | 08077-3044
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Country | US
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Telephone | 856-829-1989
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Fax | 856-829-5014
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Provider Business Mailing Address
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Address Line | 2103 BRANCH PIKE
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City | CINNAMINSON
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State | NJ
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Zip | 08077-3044
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Country | US
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Telephone | 856-829-1989
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Fax | 856-829-5014
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | MS. JENNIFER JANE KALOCHIE
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Credential | DMO
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Telephone | 856-829-1989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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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 | 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 #4
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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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