Provider Demographics
NPI:1104359967
Name:AMAR DENTAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:AMAR DENTAL ASSOCIATES LLC
Other - Org Name:PRINCETON SMILE DENTAL STUDIOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEP
Authorized Official - Middle Name:MUKESH
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:609-903-1500
Mailing Address - Street 1:328 BENCER CT
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-2304
Mailing Address - Country:US
Mailing Address - Phone:609-903-1500
Mailing Address - Fax:
Practice Address - Street 1:870 MAPLETON RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-9538
Practice Address - Country:US
Practice Address - Phone:609-951-9595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-09
Last Update Date:2017-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02599200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty