| NPI | 1760006209 |
|---|---|
| Doing Business As | SJ CENTER FOR ADVANCED DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | LADERRICK BULLOCK Owner 856-988-7773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2020-06-01 |