Provider Demographics
NPI:1528740479
Name:SOUTH JERSEY SMILES INC.
Entity type:Organization
Organization Name:SOUTH JERSEY SMILES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER- DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMAR
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:856-235-0905
Mailing Address - Street 1:200 MARTER AVE STE 800
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3147
Mailing Address - Country:US
Mailing Address - Phone:856-235-0905
Mailing Address - Fax:
Practice Address - Street 1:200 MARTER AVE STE 800
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3147
Practice Address - Country:US
Practice Address - Phone:856-235-0905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-01
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty