Provider Demographics
NPI:1194432609
Name:DENTAL ARTS & WELLNESS LLC
Entity type:Organization
Organization Name:DENTAL ARTS & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCORDAMAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:267-337-5592
Mailing Address - Street 1:1634 PULASKI DR
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-3673
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:524 LIPPINCOTT DR STE B
Practice Address - Street 2:
Practice Address - City:EVESHAM
Practice Address - State:NJ
Practice Address - Zip Code:08053-4804
Practice Address - Country:US
Practice Address - Phone:856-596-3200
Practice Address - Fax:856-596-3256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental