Individual
VITA DAVYDOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
165 OCEAN AVE, JERSEY CITY, NJ 07305-3812
(551) 554-3500
Mailing address
1000 MAXWELL LN APT 9E, HOBOKEN, NJ 07030-7890
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI03117600
NJ
Other
Enumeration date
11/25/2025
Last updated
11/25/2025
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