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Organization
TOOTHFAIRYDENTALSPA,LLC
Active
Organization
TOOTHFAIRYDENTALSPA,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARJAN HABIBIAN DDS (CEO)
(609) 452-2600
Entity
Organization
Contact information
Practice address
503 PLAINSBORO RD, PLAINSBORO, NJ 08536-2003
(609) 452-2600
Mailing address
503 PLAINSBORO RD, PLAINSBORO, NJ 08536-2003
(609) 452-2600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
17012
NJ
1223G0001X
General Practice Dentistry
Primary
17015
NJ
1223P0300X
Periodontics
22DI01847104
NJ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
22DI02022700
NJ
Other
Enumeration date
04/24/2008
Last updated
04/24/2008
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