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General NPI Number Information
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NPI Number | 1720145022
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Entity Type | Organization
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Legal Business Name | VICTORIA M CALDWELL DMD PC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 108 RIDGE RD
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City | CHERRY HILL
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State | NJ
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Zip | 08002-3022
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Country | US
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Telephone | 856-779-1375
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Fax |
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Provider Business Mailing Address
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Address Line | 108 RIDGE RD
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City | CHERRY HILL
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State | NJ
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Zip | 08002-3022
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Country | US
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Telephone | 856-779-1375
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VICTORIA M CALDWELL
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Credential | DMD
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Telephone | 856-779-1375
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DI0203930
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License Number State | NJ
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