Provider Demographics
NPI:1194854240
Name:SUNSHINE DENTAL ASSOC'S PA
Entity Type:Organization
Organization Name:SUNSHINE DENTAL ASSOC'S PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:SUNSHINE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:856-429-0577
Mailing Address - Street 1:423 QUEEN ANN RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3348
Mailing Address - Country:US
Mailing Address - Phone:856-429-0577
Mailing Address - Fax:856-665-5972
Practice Address - Street 1:1209 CHAPEL AVE W
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2209
Practice Address - Country:US
Practice Address - Phone:856-665-1998
Practice Address - Fax:856-665-5972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI00832900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty