Organization
GLOW DENTAL SPA P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEHSHAD AHKAMI D.D.S. (DOCTOR)
(973) 942-6550
Entity
Organization
Contact information
Practice address
506 HAMBURG TPKE, SUITE 101, WAYNE, NJ 07470-2068
(973) 942-6550
(973) 942-6553
Mailing address
506 HAMBURG TPKE, SUITE 101, WAYNE, NJ 07470-2068
(973) 942-6550
(973) 942-6553
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DI020826
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24362NJ
—
NJ
Enumeration date
09/03/2015
Last updated
09/03/2015
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