Provider Demographics
NPI:1063497154
Name:BELLE MEAD ORTHODONTIC CARE PA
Entity Type:Organization
Organization Name:BELLE MEAD ORTHODONTIC CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERIC
Authorized Official - Middle Name:C
Authorized Official - Last Name:STERRITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-874-8360
Mailing Address - Street 1:2139 ROUTE 206
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-4010
Mailing Address - Country:US
Mailing Address - Phone:908-874-8360
Mailing Address - Fax:908-874-5985
Practice Address - Street 1:2139 ROUTE 206
Practice Address - Street 2:
Practice Address - City:BELLE MEAD
Practice Address - State:NJ
Practice Address - Zip Code:08502-4010
Practice Address - Country:US
Practice Address - Phone:908-874-8360
Practice Address - Fax:908-874-5985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10683NJ1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty