Most Relevant Information
Provider Data
| NPI Number: | 1003647231 |
| Provider Name: | MOZHDEH NEMATOLLAHI |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | 22DI03045100 |
Most Important Dates
| Enumeration Date: | 08/09/2024 |
| Last Updated: | 08/09/2024 |
Provider Practice Location
252 MADISON AVE STE 106
PERTH AMBOY
NJ
088614314
Practice Location Phone/Fax
| Phone: | 7329976453 |
| Fax: |
Provider Mailing Location
305 PEACH ST
AVENEL
NJ
070011005
Provider Mailing Phone/Fax
| Phone: | 8482358264 |
| Fax: |