Individual
MAHNAZ FATAHZADEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
110 BEGERN STREET, NJ DENTAL SCHOOL ORAL MEDICINE CLINIC D LEVEL AREA 12, NEWARK, NJ 07103
(973) 972-1956
(973) 972-0505
Mailing address
15 JON LEIF LANE, CHESTNUT RIDGE, NY 10977
(865) 356-6084
(973) 972-0505
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DI020908
NJ
Other
Enumeration date
05/03/2006
Last updated
04/04/2019
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