Provider Demographics
NPI:1922262443
Name:VERONICA V. MATHIS, DMD, PC
Entity Type:Organization
Organization Name:VERONICA V. MATHIS, DMD, PC
Other - Org Name:MARLTON SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:VARNETTA
Authorized Official - Last Name:MATHIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:8568-108-1300
Mailing Address - Street 1:9001 LINCOLN DR W STE J
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3202
Mailing Address - Country:US
Mailing Address - Phone:856-810-8300
Mailing Address - Fax:856-810-8050
Practice Address - Street 1:9001 LINCOLN DR W STE J
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3202
Practice Address - Country:US
Practice Address - Phone:856-810-8300
Practice Address - Fax:856-810-8050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty