Provider Demographics
NPI:1720381213
Name:EDWARD MEREMINSKY DMD FAMILY AND COSMETIC DENTISTRY, LLC
Entity Type:Organization
Organization Name:EDWARD MEREMINSKY DMD FAMILY AND COSMETIC DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MEREMINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:856-662-2333
Mailing Address - Street 1:6021 MANSION BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-1100
Mailing Address - Country:US
Mailing Address - Phone:856-662-2333
Mailing Address - Fax:856-662-5644
Practice Address - Street 1:6021 MANSION BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-1100
Practice Address - Country:US
Practice Address - Phone:856-662-2333
Practice Address - Fax:856-662-5644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02303400261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental