Provider Demographics
NPI:1033497920
Name:DENTAL ASSOCIATES AT PITMAN
Entity Type:Organization
Organization Name:DENTAL ASSOCIATES AT PITMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING/INSURANCE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-589-3803
Mailing Address - Street 1:410 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PITMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08071-1047
Mailing Address - Country:US
Mailing Address - Phone:856-589-3803
Mailing Address - Fax:856-589-0371
Practice Address - Street 1:410 N BROADWAY
Practice Address - Street 2:
Practice Address - City:PITMAN
Practice Address - State:NJ
Practice Address - Zip Code:08071-1047
Practice Address - Country:US
Practice Address - Phone:856-589-3803
Practice Address - Fax:856-589-0371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD144191223G0001X
NJD195151223G0001X
NJD240831223G0001X
NJD239961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty