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General NPI Number Information
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NPI Number | 1801550017
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Entity Type | Organization
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Legal Business Name | TENBROOK ORTHODONTICS
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Dates
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Enumeration Date | 10/25/2021
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 1030 HIGH ST N
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City | MILLVILLE
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State | NJ
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Zip | 08332-2527
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Country | US
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Telephone | 856-327-7707
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Fax |
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Provider Business Mailing Address
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Address Line | 600 G ST STE 200
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City | MILLVILLE
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State | NJ
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Zip | 08332-2111
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Country | US
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Telephone | 856-413-3021
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES JOHN TENBROOK
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Credential | DMD,MMSC.
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Telephone | 609-805-0114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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