Provider Demographics
NPI:1003277278
Name:PENNINGTON FAMILY DENTISTRY LLC
Entity Type:Organization
Organization Name:PENNINGTON FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-737-0006
Mailing Address - Street 1:117 WASHINGTON CROSSING-PENNINGTON ROAD
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2510
Mailing Address - Country:US
Mailing Address - Phone:609-737-0006
Mailing Address - Fax:609-737-7776
Practice Address - Street 1:117 WASHINGTON CROSSING-PENNINGTON ROAD
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2510
Practice Address - Country:US
Practice Address - Phone:609-737-0006
Practice Address - Fax:609-737-7776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI024211001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty