Individual
KERI FORKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-5593
Mailing address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02621400
NJ
Other
Enumeration date
06/03/2015
Last updated
08/10/2016
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