Provider Demographics
NPI:1972630077
Name:JAMES E. ROCKWELL DMD PA
Entity Type:Organization
Organization Name:JAMES E. ROCKWELL DMD PA
Other - Org Name:THE SMILE CENTER OF MOUNT HOLLY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROCKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:609-267-2396
Mailing Address - Street 1:176 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-2000
Mailing Address - Country:US
Mailing Address - Phone:609-267-2396
Mailing Address - Fax:
Practice Address - Street 1:176 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-2000
Practice Address - Country:US
Practice Address - Phone:609-267-2396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI017451001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty