Individual
DR. CAROL SOUFANATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
10 FRANKLIN AVE, NUTLEY, NJ 07110-3223
(973) 667-2466
Mailing address
79 MAY ST, BELLEVILLE, NJ 07109-1712
(973) 573-0165
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02456600
NJ
Other
Enumeration date
06/22/2010
Last updated
07/13/2011
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