Individual
MISS DOREEN MARIO CHARLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
75 MONTGOMERY ST FL 402, JERSEY CITY, NJ 07302-3726
(469) 701-0851
Mailing address
10 EUGENE CIR, LINCOLN PARK, NJ 07035-1502
(832) 350-2063
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02741200
NJ
1223G0001X
General Practice Dentistry
Primary
22DI02741200
NJ
Other
Enumeration date
05/07/2018
Last updated
03/03/2026
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