Most Relevant Information
Provider Data
| NPI Number: | 1003028200 |
| Provider Name: | JUSTIN JAY FRIED D.D.S. |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | DI 20875 |
Most Important Dates
| Enumeration Date: | 05/03/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
2168 MILLBURN AVE
SUITE 201
MAPLEWOOD
NJ
070402640
Practice Location Phone/Fax
| Phone: | 9737630808 |
| Fax: | 9737630270 |
Provider Mailing Location
2168 MILLBURN AVE
SUITE 201
MAPLEWOOD
NJ
070402640
Provider Mailing Phone/Fax
| Phone: | 9737630808 |
| Fax: | 9737630270 |