Provider Demographics
NPI:1447696810
Name:ASAD S. SADIQ DMD PA
Entity type:Organization
Organization Name:ASAD S. SADIQ DMD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILDKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-893-5200
Mailing Address - Street 1:PO BOX 661
Mailing Address - Street 2:
Mailing Address - City:BROWNS MILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:08015
Mailing Address - Country:US
Mailing Address - Phone:609-893-5200
Mailing Address - Fax:609-893-7271
Practice Address - Street 1:77 JULIUSTOWN ROAD
Practice Address - Street 2:
Practice Address - City:BROWNS MILLS
Practice Address - State:NJ
Practice Address - Zip Code:08015
Practice Address - Country:US
Practice Address - Phone:609-893-5200
Practice Address - Fax:609-893-7271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223G0001X
NJ13540261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty