Individual
DR. MITRA ABDOLLAHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
3 N WHITE HORSE PIKE, SOMERDALE, NJ 08083-1740
(856) 782-0800
(856) 782-7868
Mailing address
3 N WHITE HORSE PIKE, SOMERDALE, NJ 08083-1740
(856) 782-0800
(856) 782-7868
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D019160
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1035795
—
NJ
05
—
6618901
—
NJ
Enumeration date
05/23/2007
Last updated
07/08/2007
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