# MONMOUTH MALL DENTAL, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437591567
- **Authorized official:** DR. ALEXANDER MIKHAILOV DDS (PRESIDENT)
- **Authorized official phone:** (201) 626-2500

## Contact information

- **Practice address:** 180 ROUTE 35 S, EATONTOWN, NJ 07724-2023
- **Practice address phone:** (201) 626-2500
- **Mailing address:** 180 ROUTE 35 S, EATONTOWN, NJ 07724-2023
- **Mailing address phone:** (201) 626-2500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 19779 | NJ | Yes |

## Other

- **Enumeration date:** 07/17/2013
- **Last updated:** 07/17/2013