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Organization
EAST BRUNSWICK PERIODONTICS AND DENTAL IMPLANTS
Active
Organization
EAST BRUNSWICK PERIODONTICS AND DENTAL IMPLANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIMA MIR MADJLESSI DDS, MS, PA (DOCTOR)
(732) 651-8470
Entity
Organization
Contact information
Practice address
E 7 BRIER HILL CT, EAST BRUNSWICK, NJ 08816-3336
(732) 651-8470
(732) 651-8033
Mailing address
E 7 BRIER HILL CT, EAST BRUNSWICK, NJ 08816-3336
(732) 651-8470
(732) 651-8033
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
20508
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659303329
NATIONAL PROVIDER IDENTIF
NJ
Enumeration date
01/30/2007
Last updated
08/22/2020
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