Provider Demographics
NPI:1760905897
Name:PEACEFUL DENTAL CARE
Entity Type:Organization
Organization Name:PEACEFUL DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEI
Authorized Official - Middle Name:
Authorized Official - Last Name:XU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:609-632-2155
Mailing Address - Street 1:300A PRINCETON HIGHTSTOWN RD STE 104
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1421
Mailing Address - Country:US
Mailing Address - Phone:609-632-2155
Mailing Address - Fax:888-225-4310
Practice Address - Street 1:300A PRINCETON HIGHTSTOWN RD STE 104
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1421
Practice Address - Country:US
Practice Address - Phone:609-632-2155
Practice Address - Fax:888-225-4310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty