MEDFORD PERIODONTAL ASSOCIATES LLC NPI 1184808743

NPI Information

MEDFORD PERIODONTAL ASSOCIATES, LLC is a periodontics dentist in Medford, NJ. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. MEDFORD PERIODONTAL ASSOCIATES, LLC NPI is 1184808743. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

30 JACKSON RD
SUITE A-5
MEDFORD, NJ
ZIP 08055-283
Phone: (609) 953-3700

The provider's authorized official is Mario J Canal .
The authorized official title is Owner and has the following contact phone number (609) 953-3700.

The enumeration date for this NPI number is 12/19/2007 and was last updated on 12/19/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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